Public health plans to cover primary care by nurse practitioners and midwives in 2026

Provincial and territorial health plans are set to undergo a significant change starting April 1, 2026, as non-physician health-care professionals such as nurse practitioners, pharmacists, and midwives will now be able to bill the government for medically necessary services. This new interpretation of the Canada Health Act, announced by federal Health Minister Mark Holland, aims to ensure that all Canadians have access to essential care without having to pay out of pocket.

Holland emphasized that the move is necessary to align with the principles of universal health care, as some patients have been forced to cover the costs of necessary treatments, including at private nurse practitioner clinics. By allowing nurse practitioners to bill the health-care system in the same way doctors do, Holland hopes to eliminate barriers to essential care and provide a more inclusive health-care system.

In a directive issued to provincial and territorial health ministers, Holland highlighted the importance of empowering non-physician health-care professionals to deliver the full spectrum of care they are qualified to provide. This shift not only expands the scope of practice for these professionals but also helps alleviate the strain on primary care physicians and the health-care system as a whole.

Michelle Acorn, CEO of the Nurse Practitioners’ Association of Ontario, hailed the decision as a significant win for the advocacy efforts of non-physician health-care professionals. She noted that nurse practitioners have faced challenges in billing the government for their services, leading some to charge patients directly. With this new policy in place, Acorn believes that timely access to health care will be more readily available to all individuals.

The changes will be enforced through federal health transfer payments to provinces and territories, with potential deductions for those still charging patients for medically necessary care. Ontario Health Minister Sylvia Jones is currently reviewing the directive to understand its impact on the delivery of publicly funded care in the province.

This initiative, which comes almost two years after concerns were raised about patients paying out of pocket for necessary treatments, represents a step towards ensuring equitable access to health care for all Canadians. By clarifying the roles and billing practices of non-physician health-care professionals, the government aims to uphold the principles of the Canada Health Act and provide comprehensive care to those in need.