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Council of the Federation Meeting, Summer 2026 – Wrap Memo

July 24, 2026

Background

July 24, 2026 – As Chair of the Council of the Federation (COF) this year, Premier of Prince Edward Island (PEI), Rob Lantz, hosted the Summer Meetings of the Premiers and First Ministers in Charlottetown. The meetings were set against the threat of a deepening recession, a stalled renewal of the Canada-United States-Mexico Agreement (CUSMA), and fresh tariffs from the United States (U.S.) — economic pressures that certainly helped shape every conversation throughout the past couple days.

The previous Winter Meeting, held in Ottawa in late January, set an ambitious bar. The Premiers backed federal plans to fast-track nation building projects, reduce regulatory red tape, and advance labour mobility. Since then, Canada’s economy has slid into a technical recession, squeezing the ability for all levels of government to invest in key priorities, such as housing and health care. Additionally, just this week, the President of the United States, Donald Trump, announced new tariffs of  50% on many Canadian goods, setting the stage for a contentious discussion around the future of trade with the country. 

Top Line for Health and Life Sciences

Premiers focused their initial discussions over July 21-22 on health care, safe communities, cost of living and affordability, economic growth, and strengthening Arctic security and sovereignty. A primary concern for Premiers was the future of CUSMA and Canada’s general trade relationship with the U.S. They set the tone early by calling on Prime Minister Carney to better engage with the provinces and territories during these negotiations. They also indicated support for the federal government’s efforts on protecting youth from online harms, confirming they are aligned with Bill C-34, the Safe Social Media Act, and encouraging rapid adoption of the legislation. 

With regards to health care more specifically, Premiers were primarily focused on access to timely and appropriate health care services, including treatments and medicines. They called on the federal government to renew funding agreements set to expire throughout the next few years, including Aging with Dignity, Drugs for Rare Diseases, and mental health and addictions funding. They also sought a commitment from the federal government to continue a minimum 5% Canada Health Transfer (CHT) growth rate annually rather than letting it revert back to 3% after March 31, 2028, as currently planned. New Brunswick Premier Susan Holt pointed out in the post-meeting press conference that the federal share of health costs had dropped to 21%, well below the 50-50 cost-share agreement under the original National Hospital Insurance Act of 1957. 

Premiers also emphasized that, within the next two years, they want a long-term federal commitment to flexible and sustainable funding that supports provincial and territorial health care priorities and ensures the continued delivery of quality care and support investments in health infrastructure. The inclusion of this language, the strongest related to health care in a Council of the Federation communiqué since 2023, could help to set the stage for a renewed, united push from provinces and territories for more stable, ongoing funding for health care. In 2022-23, similar calls for action resulted in the creation of the Working Together Plan, providing $25 billion in new funding to provinces and territories and establishing the current time-limited minimum 5% CHT growth rate. 

In the First Ministers meeting on July 23, the focus was on Canada-U.S. relations, strengthening Canada’s energy independence, labour mobility, internal trade, and making Canada’s carbon markets more effective. First Ministers agreed that strengthening internal trade and enhancing labour mobility is key to unlocking Canada’s full economic potential, and agreed to accelerating work in this area. This will include working towards an agreement in principle by the end of 2026 to adopt model mutual recognition legislation to create one Canadian market and support labour mobility. When providing examples of what this work could mean during the post-meeting press conference, First Ministers pointed to the fact that in an ideal Canada, an Ontario-licensed nurse should be able to work in Nova Scotia without a lengthy, new approval process.

First Ministers also agreed to direct their Ministers of Health and Finance to discuss longer-term funding solutions for the health care sector. When asked about this topic in the post-meeting press conference, Prime Minister Carney deferred to the work that will be undertaken by the relevant Ministers, indicating he is aware of the funding cliff that is approaching but emphasizing that there is still runway ahead of that cliff. Premier of Manitoba, Wab Kinew, and Premier of British Columbia, David Eby, both took the opportunity to stress the importance of not losing sight of this key file as a result of the current focus on U.S. trade tensions, and the need to have some sense of their funding levels as they work through their respective budgetary processes.

Santis Insights

  • The Economy and Trade Remain the Core Focus of the First Ministers: With the unpredictability Canada is facing through the current trade tensions with the U.S., economic strain and trade remain at the forefront of the conversation at the First Ministers’ table. This is unlikely to change until more stability is achieved — likely only through a renewal of CUSMA. This means that stakeholders in the health and life sciences sector will have to continue to manage being lower on the priority list with the federal government, and should continue trying to tie any advocacy language or budget proposals into economic arguments where possible. 
  • Premiers Coordinated on Trying to Bring Attention Back to Health Care: As demonstrated through the Santis–Nanos Canadian Health Perspective polling, 70% of Canadians report feeling “worried” or “frustrated” by the current state of care in Canada, and 91% agree it is important for the system to change now. Canadian politicians who ignore this public sentiment and fail to act do so at their peril in the current political environment. It’s no surprise that Premiers are coordinating efforts to bring attention back to adequate funding for the health care system amid strained provincial coffers, while also trying to manage the fallout from U.S. trade wars and geopolitical stressors on supply chains.
  • Alberta’s Bill 11 Flashpoint: Health coalitions rallied in Charlottetown demanding Premiers publicly reject two-tier care and that Prime Minister Mark Carney and federal Health Minister Marjorie Michel enforce the Canada Health Act. One advocate warned that, by September, Albertans will face legislated queue-jumping for surgeries, contravening the Act. Advocates want any funding increase to Alberta to come with conditions, not a “blank cheque”. 
  • Funding Without Conditions Likely to Remain Point of Contention: Premiers continue to emphasize that long-term, sustainable funding must remain flexible and unconditional to allow for jurisdictions to respond to their localized needs and evolving circumstances. However, for the first time ever, there is clear public opposition to the Premiers making this request, specifically targeted at Alberta’s play for private diagnostic clinics. With health costs rising rapidly and no new revenue streams to match, provinces are starting to feel the pressure. Should the federal government proceed with new funding allocations, it is feasible that they will continue to try and include some level of accountability measures in an effort to ensure that federal money is being used as prescribed, similar to the efforts undertaken in the Working Together agreements, rather than simply increasing the Canada Health Transfer which has limited oversight available. 

Looking Ahead

The upcoming Health Ministers Meeting, being hosted in Winnipeg from October 15-16, will be the next opportunity for all levels of government to come together and discuss health-related funding and bilateral agreements. If the provinces and territories are truly united in coordinating a strong push on the federal government to resolve this funding cliff ahead of their respective 2026 budgetary processes, we are likely to see a ramp up of pressure around this meeting.

With regards to the Council of the Federation, as of August 1, 2026, Northwest Territories Premier R.J. Simpson will assume the Chair role, and will host the next Summer Meeting of Canada’s Premiers on July 14-15, 2027.

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