Ontario will not meet the federal government’s April 1 deadline to publicly fund all medically necessary services delivered by nurse practitioners-leaving many patients paying out of pocket for primary care.
Health Minister Sylvia Jones previously urged Ottawa to close a “loophole” in the Canada Health Act that allowed private, fee-based nurse practitioner clinics. The federal government has since clarified that such services must be covered under public funding-but Ontario says it’s still reviewing implementation.
Provinces won’t face financial penalties until April 2027, but critics say delay undermines access. Michelle Acorn, CEO of the Nurse Practitioners Association of Ontario, called for immediate action: “Flexible funding mechanisms will support nurse practitioners in delivering timely, high-quality care.”
Nurse practitioners can assess, diagnose, prescribe, and treat patients across hospitals, long-term care homes, and community clinics-including over two dozen publicly funded nurse practitioner-led clinics in Ontario.
Yet demand outstrips supply. Maryanne Green, a nurse practitioner in Kingston, opened a subscription-based clinic after her 2023 application for public funding was rejected. Her clinic charges $1,800 annually for primary care.
“I’m not charging because I want to,” Green said. “It’s the only way to move forward.” She hopes Ontario’s eventual funding model will be sufficient to sustain quality care without private fees.
Opposition leaders accuse the province of hypocrisy. Liberal health critic Dr. Adil Shamji said the government “prefers patients pay out of pocket than fund public care.” NDP critic Dr. Robin Lennox urged flexible models that let nurse practitioners work independently-especially in rural areas where physician shortages persist.