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The United Conservative Party government will press ahead with its plan to opt out of federal dental and drug benefit programs in favour of its own made-in-Alberta approach, even though voters rejected a similar strategy in last week’s referendum.
Alberta has been looking to go its own way on the Canadian Dental Care Plan (CDCP) and the national pharmacare program since 2024. The provincial government has argued that it should receive its share of federal funding in order to reshape programs as it sees fit.
Last week, Albertans were asked in a referendum if they thought the province should lead a broad push to amend the Constitution so provinces could opt out of federal programs while using Ottawa’s cash for its own, establishing a blanket opt-out rule.
But voters rejected the UCP proposal, with 57 per cent of voters saying no.
Despite the result, a government spokesperson said Alberta plans to move forward on those two high-profile policy fronts of dental and pharmacare.
“Alberta will continue to call on the federal government for predictable, sustainable, unconditional health funding that respects provincial jurisdiction,” wrote Maddison McKee, press secretary for the Ministry of Hospital and Surgical Health Services, in a statement.
“Our government will continue advocating for Alberta’s fair share of federal funding to strengthen our comprehensive dental and drug programs.”
The province previously said it would pursue an independent path on the CDCP by 2026. McKee did not immediately respond to a request for comment looking for more details about an updated timeline.
As of Sept. 30, there were 349,000 Albertans enrolled in the CDCP for the 2026-2027 benefit period, 91,000 of whom had received an approved claim, according to the federal government.
Rejected universal opt-out rule
In essence, the referendum proposed a change to what’s known as constitutional spending power. In the event of a “yes” vote, Alberta would have had to get the support of Parliament and at least seven provinces representing at least half of Canada’s population in order to change the Constitution.
There are four questions relating to Canada’s Constitution for Albertans to consider in the referendum. CBC’s Joel Dryden breaks down each one to look at what happens if you vote ‘yes’ or ‘no.’
Governments like Alberta have argued that Ottawa often imposes conditions on transfer funds and in doing so intrudes into areas of provincial jurisdiction.
Constitutional experts who spoke to CBC News before the vote noted scholars take different perspectives on this arrangement. Some said Alberta had a point on the matter, arguing that the spending power is unconstitutional or that it could be open to future litigation.
Any constitutional amendment would be a steep hill to climb.
But viewing this ballot question solely as a constitutional question was “always misleading,” in the view of André Lecours, a University of Ottawa political scientist whose research focuses on federalism.
“That question is really about how federalism works in Canada,” he said, adding that its failing was “the most interesting, surprising and maybe important” of them all.
“Certainly in Quebec, this is an absolute gimme,” he said.
André Lecours is a professor in the School of Political Studies at the University of Ottawa who specializes in Canadian politics. (Submitted by André Lecours)
Formally, the question failing doesn’t prevent the provincial government from withdrawing from recently-created federal programs, Lecours said. Alberta could still point to a roughly 50-50 split on the question or note that the question dealt with a general principle rather than specific policies.
Provinces can reject federal money today if they don’t like the conditions attached. But if the two levels of government can’t come to an agreement, that can mean leaving money behind.
“It will be interesting to see how the federal government wants to play it. Does it want to bring up the result on Question 8 to say, ‘Look. I’m not sure that you have a great legitimacy to do this?’” he said.
Negotiations to come
The CDCP, of course, is a federal insurance plan — Canadians opt in or opt out — while the national pharmacare program is an opt-in program, noted Fiona Clement, director of the Centre for Health Policy at the University of Calgary’s Cumming School of Medicine.
It means that this ballot question wouldn’t have had an immediate impact on those programs. But Clement noted that more debates are on the horizon, including around federal health-care agreements.
“What I really hope this enables is the ability for the different levels of government to get on with the hard work that we need to do,” Clement said.
Gerard Kennedy, a constitutional law professor at the University of Alberta, said the provincial government’s comments signal they are going to continue to pursue their priorities and their views on provincial jurisdiction.
But they do so with a weaker hand, he said.
“The fact that we voted ‘no’ probably means the federal government, from a political perspective, feels particularly strong in saying ‘no,’” he said.
