Alberta’s U.S.-style health care reforms will increase costs for businesses

In December 2025, the Alberta government introduced Bill 11 (the Health Statutes Amendment Act, 2025, no. 2), which is expected to take full effect this fall. The Alberta government also implemented Bill 29 (the Health Statutes Amendment Act, 2026) in July, which allows patients to access “preventative health testing services” without referrals if they pay for them. 

This has major implications of Alberta’s private health care reforms for patients and the public system, but there are also big cost implications for employers and businesses.

Together, these new laws are likely to significantly increase business and employer health care costs—just as private health insurance drives up business costs in the United States. 

The public plan pays last if there is private coverage

This fall, the public Alberta Health Care Insurance Plan (AHCIP) and public Alberta Blue Cross Plan (called the Non-Group Coverage) become the “payor of last resort” if there is private coverage for publicly and non-publicly insured health services and drug costs. This means that, if a private insurance plans covers a given medical service, the private plan pays, rather than the public health insurance system. Previously, the public system went first and private insurance served to fill gaps.

The AHCIP—like the Ontario Health Insurance Plan and B.C.’s Medical Services Plan—is the provincial health insurance plan (the “public plan”) covering medically necessary hospital and physician services. Alberta’s Non-Group Coverage provincially-negotiated supplementary group insurance plan available for Alberta residents 65 and younger that provides some coverage for prescription drugs, home nursing care, diabetes supplies, and other benefits.

After Bill 11 takes full effect, the costs previously covered by AHCIP—prescription drugs costs as the largest existing item—will fall onto employer-sponsored group plans. Private insurers and industry observers note that insurance companies will increase the price they charge employers for group plans.

Employers and private plans must maintain coverage for all active employees 

Bill 11 prohibits employer-sponsored private insurance plans from denying coverage to employees based on age. These employer-sponsored plans must now provide coverage for all employees, now including those who are 65 and over, which will provide insurance companies a rationale to increase group plans and employer costs. 

Prior to Bill 11, employees who are no longer eligible for employer-sponsored supplemental private health insurance, such as those over 65, accessed the provincially negotiated Alberta Blue Cross Coverage for Seniors. Private insurers and industry observers suggest that employer costs will increase as a result.

Transferring costs to employers

Under Bill 11, once private insurance plans begin providing duplicative coverage for publicly insured services, private insurers must pay. When “non-Plan” services are provided by “flexibly participating” or “non-participating” physicians—even if these are also publicly insured—reimbursement under the public AHCIP will not be possible.

Under Bill 29, the Alberta government introduced “self-referral” for diagnostic testing (allowing people to access testing without a physician referral), beginning with CT, MRI, ultrasound, and x-ray. Bill 29 encourages employer-sponsored plans to provide coverage for these “preventative health testing services.” 

Insurance companies are likely to pass the costs of the increased demand for these tests onto employers through higher premiums. The public plan will only provide reimbursement if the test results in a cancer diagnosis and only after private coverage has been exhausted.

Bills 11 and 29 download health care costs onto employers. There is a high likelihood that employers providing private health insurance will face higher premiums upon renewal in order to maintain existing coverage and as the industry seeks to absorb the additional costs of these provincial changes. 

Employers and businesses will need to understand how these changes will impact their budgets. They should also urge the province not to shift costs onto employers and businesses. Universal public health insurance has not only been key to superior health outcomes and greater affordability in Canada compared to the United States—but it also remains a significant economic benefit for businesses of all sizes.

About the author

Andrew Longhurst

Andrew Longhurst is a senior researcher and political economist, with a focus on health policy, at the Canadian Centre for Policy Alternatives. His work has been published in academic journals and by research institutes, including Canadian Journal on Aging, Political Geography, the CCPA, and the Parkland Institute.