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As the federal Liberals unveil their second budget, there is no guarantee that funding for provincial health care will remain stable after 2028.
In B.C., that could prove a challenge for the province’s incoming Conservative government, which ran on promises to improve the health-care system and manage the province’s ballooning deficit.
The Canada Health Transfer is the largest major federal transfer to provinces and territories, providing long-term funding for health care.
In October, provincial health ministers gathered to warn of a looming “fiscal cliff” if they aren’t increased.
Transfers have grown by a guaranteed five per cent every year since 2023, but that is scheduled to dip to a minimum three per cent increase starting in 2028.
Health care has been a key concern for British Columbians, after critical family doctor shortages and regular emergency room closures across the province.
The incoming B.C. Conservatives recently campaigned successfully on pledges to keep rural emergency rooms and maternity wards open, expand long-term care, cut health-care wait times and recruit more doctors.
In a statement, a Conservative Party of B.C. spokesperson said “there were positives for British Columbia in the federal budget and there are areas where additional investment will be needed to support British Columbians and strengthen our economy.”
“As we move through the transition period, we are reviewing the budget carefully and assessing how it aligns with the commitments we have made to the people of British Columbia.”
3% increase ‘not sustainable’
Ravi Kahlon, B.C.’s former minister of health, said a three per cent increase in 2028 and beyond is not sustainable, with most provinces’ health care costs climbing by seven per cent or more.
“There are multiple agreements with the federal government that still need to be renewed when it comes to seniors and care for mental health and addiction support,” he said.
“The dollars are just not there in this budget to be able to address those pressures. It’s going to be on the new government to make sure they do the advocacy for the federal government to provide their portion.”
In October, the federal government granted a one-year extension to a deal supporting mental health, addictions and home care services.
But health ministers at the time warned that without boosting transfers or renewing other funding agreements, provinces would not be able to keep programs afloat.
During their fall campaign the B.C. Conservatives promised to increase services, cut taxes, and reduce B.C.’s deficit.
The party said on Friday that once ministers are sworn in, they will have a mandate to “advocate strongly for the federal investments and resources British Columbia needs to succeed.”
Debt payments now exceed cost of health transfers
While the Canada Health Transfer represents the largest major federal transfer to provinces and territories, it’s far from the biggest line item in the budget.
According to fiscal documents, the cost to finance Canada’s roughly $1.3-trillion national debt will jump from $60.2 billion in 2026-27 to $85.5 billion in 2030-31.
That exceeds what the government spends on some crucial programs, including the Canada Health Transfer.