Oct 20, 2026
U.S. President Donald Trump has lodged a new version of an old complaint against Canada. At a rally in Highland Heights, Kentucky, on Oct. 17, he told supporters the U.S. is “losing” US$90 billion a year “for the privilege of allowing Canada to have a health-care system and other things that they shouldn’t be having.”
Afterwards came the jab: “They spend our money very unwisely.”
Does the U.S. actually pay for Canadian health care?
Trump’s assertion is that America pays for — or, at least, subsidizes — Canada’s healthcare, but is his claim true? No. And Trump offered no evidence to corroborate his claim.
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His claim, however, may be a reference to trade. According to USAFacts, a non-partisan U.S. non-profit that compiles government data, America’s goods and services deficit with Canada shrank to US$27.3 billion in 2025. Much of what Americans buy from Canada is fuel. The U.S. Energy Information Administration (EIA), the country’s federal energy statistics agency, says the nation’s energy imports from Canada were worth US$111 billion last year, with crude oil topping the list. A trade deficit essentially means American buyers paid for products they received — it isn’t a cheque directly to Ottawa.
So who foots the bill? Canadians do, through taxes that are handled both provincially and federally. The provinces and territories are responsible for delivering care, as each runs its own health insurance plan, decides which services count as medically necessary and regulates providers such as doctors and nurses.
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The federal government sets national standards under the Canada Health Act and funds the provinces and territories directly through the Canada Health Transfer, plus other fiscal transfers. That transfer is expected to rise to CA$54.7 billion in 2025-26, according to the Department of Finance Canada. To receive their full payment, provinces and territories must meet the Act’s standards, which include covering all residents and providing access based on medical necessity rather than an ability to pay for the services.
While Trump’s jab may be a catchy line for a U.S. campaign stage, for Canadian households, the more useful question isn’t what Washington thinks it’s subsidizing; it’s what you’re paying, even in a universal health care system.
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How much does a typical Canadian family pay for ‘free’ health care?
According to its study The Price of Public Health Care Insurance, 2026, the Fraser Institute, an independent fiscally-conservative Canadian think tank, estimates that a two-parent, two-child family with an average household income of CA$202,885 will pay $21,115 for public health care this year. Furthermore, single Canadians will pay about CA$6,464 while the lowest-earning 10% of families will pay roughly CA$637. Since 1997, the institute says, the cost has risen 2.3 times as fast as food prices, 1.5 times as fast as shelter and 1.7 times as fast as average income.
Keep in mind this is a modelled estimate that assigns a share of each family’s total tax bill to health care. It’s not an invoice.
Which health costs still have you paying out-of-pocket?
The Canadian Institute for Health Information (CIHI), an independent not-for-profit that tracks health data, estimates total health spending reached CA$399 billion in 2025, with the public sector covering about 71% of these costs. The rest comes out of Canadians’ own pockets and private insurance plans.
But the share of privately funded health care is growing faster than the public. The Canadian Centre for Policy Alternatives (CCPA), a progressive research institute, found that per-person private health spending in Canada rose 8.1% from 2021 to 2023, compared to public health spending at 4.3%. Private spending averaged CA$2,602 per person in 2023. According to the CCPA, 77% of private health spending in 2023 went to just three areas: non-physician professionals such as dentists, physiotherapists and psychologists (32%), drugs (30%) and long-term care (15%).
Keep in mind, these figures pre-date the full rollout of the Canadian Dental Care Plan, which has subsequently cut the share of Canadians without dental coverage from 35% to 25%, according to the Canadian Dental Association via CTV News. This means that dental costs may now make up a smaller slice of private spending.
Statistics Canada data show out-of-pocket health-care costs have risen 18.5% since 2022, CBC News reports, with physiotherapy, basic dental care and eye exams each up about 20%.
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Canadians who don’t have workplace benefits — including many self-employed workers, contract staff and retirees — tend to feel these costs most directly.
What to do now
Cross-border rhetoric is out of your hands, but how you manage your health costs isn’t.
Claim the medical expense tax credit
According to the Canada Revenue Agency, you can claim eligible medical expenses above CA$2,834 or 3% of your net income, whichever is less, for the 2025 tax year. The threshold is indexed each year — so check the 2026 figure before filing your taxes next year. Additionally, couples usually get more by claiming on the lower-income spouse’s return.
Check the Canadian Dental Care Plan
You may qualify if your adjusted family net income is under CA$90,000 and you have no access to private dental insurance or coverage, including a health spending account that covers dental costs, according to the Government of Canada.
How much the plan pays depends on income. For families earning less than CA$70,000, it will cover 100% of established fees; families earning CA$70,000 to CA$79,999 will have to foot 40% of those fees; families making between CA$80,000 and CA$89,999 will have to pay 60%. Since the plan’s fees may not match what your dentist charges, ask about any extra costs before receiving treatment.
Look up provincial drug coverage
National pharmacare is still in its early days. The Canadian Medical Association (CMA), the national organization representing Canada’s physicians, notes that the program’s first phase covers diabetes medications and supplies — such as insulin and blood glucose sensors — as well as contraceptives. So far, only three provinces and one territory have signed on: Prince Edward Island, Manitoba, British Columbia and Yukon. Residents there who qualify for their provincial health plan are automatically covered and don’t need to apply.
Everywhere else, provincial plans can fill some of the gaps. Every province runs drug programs for low-income families and seniors, and some, such as Ontario’s Trillium Drug Program, help residents who face high prescription costs. Check what your province offers to see if you can avoid paying full price at the counter.
Use your benefits before they reset
Most workplace plans and health spending accounts run on a calendar year. Make sure to book dental, vision or physio appointments before Dec. 31 so any unused coverage doesn’t go to waste.
In the end
While President Donald Trump claims that the U.S. loses US$90 billion annually to fund Canadian health care, the assertion is inaccurate and unsupported by current and past evidence. Rather than directly financing Canada’s universal system, any financial exchanges between the two nations stem from bilateral trade, such as U.S. energy imports.
In truth, Canadian healthcare is actually funded by Canadian citizens through federal and provincial taxes, with provinces handling service delivery while the federal government sets national standards and provides fiscal transfers.
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Writer and editor based in Toronto with experience in personal finance, insurance, arts and culture and branded content.
