Bill C-239 Canada Health Act Accountability

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C-239 An Act to Amend the Canada Health Act (Accountability)

Bill Type: Private Member’s Bill

Bill Sponsor: Sukh Dhaliwal (Surrey Newton)

Status: Introduced — 1st Reading, September 22, 2025. This Bill hasn't passed yet.

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WHAT IS THE CANADA HEALTH TRANSFER?

The Canada Health Transfer (CHT) is the largest federal transfer payment to provinces and territories. It is the primary way the federal government funds provincial health care systems — covering hospitals, doctors and medically necessary services. In 2024–25 the CHT totaled approximately $49.4 billion. Provinces received their share based on population. There are currently very few conditions attached to receiving it.

WHO GAINS POWER

  • The federal government gains authority to reduce or withhold Canada Health Transfer payments from any province that fails to implement an accountability framework
  • The Governor in Council gains authority to determine when a province is in default and to impose or continue financial penalties year over year
  • Canadians gain the right to see their province's accountability framework and annual performance reports on a publicly available website
  • ⚠️ This Bill comes into force by Order in Council — Government decides if and when it takes effect, with no deadline specified

WHO LOSES POWER

  • Provincial governments lose unconditional access to their full Canada Health Transfer payment — compliance with the accountability framework becomes a condition of receiving federal health funding
  • Provinces lose flexibility to define health care performance on their own terms — benchmarks must cover primary care, elective procedures and emergency care
  • ⚠️ The benchmarks themselves are set by each province — the federal government does not set the standards, only requires that standards exist and are reported on

WHO GAINS MONEY

  • No new money is created by this Bill
  • Provinces that comply fully retain their existing Canada Health Transfer entitlement

WHO LOSES MONEY

  • Provinces that fail to implement an accountability framework risk losing a portion of — or their entire — Canada Health Transfer cash contribution
  • Reductions continue year over year for as long as the default continues
  • ⚠️ No minimum or maximum penalty amount is specified — the Governor in Council determines the size of the reduction

THE CATCH

  • Provinces set their own benchmarks — a province could set low targets, meet them easily and remain fully compliant without meaningfully improving health care access
  • Consultation between provinces and the federal Minister is optional, not required
  • ⚠️ "Timely access" and "efficiency of health care spending" are not defined in the Bill — provinces determine what these mean in their own frameworks
  • ⚠️ No enforcement mechanism exists if a province publishes a framework but ignores it — the Bill requires publication and reporting, not achievement of benchmarks
  • The Bill comes into force only when Government chooses to proclaim it — it could pass and never be activated

Source: Bill C-239 — An Act to amend the Canada Health Act (accountability), 45th Parliament, 1st Session