Authored by Chaten Jessel & Bernard Ho

Earlier this month, Federal Health Minister Mark Holland finally released the long-awaited Canada Health Act Policy Interpretation Letter. He clarified that any health care professionals delivering “physician equivalent services” are prohibited from charging patients or their employee benefit plans for medically necessary services otherwise covered by Medicare. Provincial and territorial governments have until April 2026 to put an end to unlawful billing practices, or face deductions from the Canada Health Transfer payments.

While this marks a victory for patients, it comes with a glaring omission. The original intent of this letter was to also prohibit health care providers from charging patients or their employee benefit plans for medically necessary services when delivered virtually, such as by phone, live videoconference, or text message. Failing to explicitly mention virtual care too leaves the issue unresolved, inadvertently allowing some jurisdictions to continue to skirt the intent of the law

This omission is no accident. Insurance companies, Chambers of Commerce, and large virtual care corporations successfully lobbied the federal government to leave out (at least for now) this essential clarification about how we interpret the Canada Health Act. These corporate lobbyists groups have spoken out against specifically including medically necessary virtual care, claiming this could jeopardize employee virtual care coverage.  They have pressured governments at all levels to exclude employer-funded virtual care from public funding, thereby ensuring that insurance companies will continue to profit from selling or administering plans that include this benefit.

Their claims are intentionally misleading. They argue that 10 million Canadians would lose access to virtual care through workplace insurance, unless exceptions are made. This is not true: rather than funding virtual care through employee benefit plans, these services would simply be publicly funded by provincial and federal governments. This would ensure that medically necessary virtual care is available to everyone—just like all other medically necessary care. This explicit inclusion of publicly-funded virtual care would also guarantee the other 31 million Canadians who lack workplace insurance could access virtual care without paying out of pocket.

Publicly funding medically necessary virtual care would improve access for all Canadians, not just those fortunate enough to have stable jobs with benefits.

It is disappointing that the federal government appears to have prioritized the interests of health insurance companies and profit-driven virtual care corporations over the health and equity of Canadians. Evidence from Canada and abroad makes it clear that private-pay health care does not solve systemic issues. Instead, it benefits only those who can afford it, along with the corporations and physicians profiting from it. Health policy decisions must be driven by public need—not corporate profit.

Thankfully, virtual care is here to stay—let’s ensure it is accessible to everyone, not just the 25% of Canadians lucky enough to have employee benefit plans.  Minister Holland still has the chance to make this right. With the upcoming Health Ministers’ Meeting at the end of the month, he can put this on the agenda and issue further clarification that patients must not pay out of pocket, or through their employee benefit plans, for medically necessary care, regardless of how it is delivered.

Chaten Jessel is a medical student at the University of Calgary, and Vice-Chair of Communications of Canadian Doctors for Medicare

Bernard Ho is an emergency and family physician in Toronto, and Executive Vice-Chair of Canadian Doctors for Medicare