PREMIERS

Spetember 15, 2016

The Right Honourable Justin Trudeau, P.C., M.P.
Prime Minister of Canada

Of?ce of the Prime Minister

Langevin Block, 80 Wellington Street

Ottawa, ON KIA 0A2

Dear Prime Minister:

During our meeting in Whitehorse in July, Premiers had the opportunity to discuss the various
challenges facing their respective health care systems, including ?nancing these systems within
the context of steadily increasing costs.

All Premiers raised concerns about the decision of the previous federal govemment to amend the
annual growth rate of the Canada Health Transfer (CHT) next year, and the signi?cant impact
that these changes will have on provinces? and territories? (PT) ?nances.

As you know, starting in 2017-2018, the rate of funding is expected to change from 6 per cent to
grow in line with a three-year moving average of nominal Gross Domestic Product (GDP),
subject to a ?oor of 3 per cent. Beginning in the next ?scal year, the budgetary impact for all PTs
could represent a revenue decline of $1 billion in 2017 -201 8 alone.

Canada?s Premiers have directed PT Finance Ministers to develop options for increased federal
funding through the CHT. Finance Ministers will be coordinating work with PT Ministers of
Health to focus our efforts. Provinces and territories believe that a long?term agreement is
achievable, and we are committed to working with your government to make this happen.

With the 2017-2018 federal budgetary cycle beginning in the coming weeks, it is important that
First Ministers act before these changes begin impacting Canadians. It is for this reason that on
July 22, we asked you to meet with us in the fall to discuss this issue.

Premiers would like to hold a meeting with you solely dedicated to long-term health care
?nancing before mid-December.

In the spirit of collaboration and to re?ect the importance of this issue, we believe that this

meeting should be con?rmed prior to the First Ministers' Meeting on climate change and clean
growth.

If a meeting on long-term health care ?nancing is not possible within the proposed time frame,
we ask that you formally commit to postponing the entry into force of the proposed CHT
changes for at least one year. This will give us the opportunity to reach an agreement that re?ects
intergovernmental collaboration and is respect?Jl of PT jurisdiction, which we believe will be to
the bene?t of all Canadians and the Canadian federation.

Sincerely,

Omicron;

Darrell Pasloski
Chair, Council of the Federation
Premier of Yukon

cc: Premiers