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Prime Minister Justin Trudeau shakes hands with Alberta Premier Danielle Smith during a meeting in Calgary on March 13.Dave Chidley/Reuters

Alberta’s Premier wants Ottawa to revise its national pharmacare proposal, designed to cover birth control and diabetes medication for all, so it offsets the cost of thousands of drugs for people in her province who do not have any form of insurance.

Danielle Smith, speaking to reporters after meeting with Prime Minister Justin Trudeau in Calgary on Wednesday, said she would rather expand Alberta’s existing coverage system to include more uninsured residents than participate in a parallel program that would leave thousands of people still paying out of pocket for medicines.

Mr. Trudeau, speaking at a separate press conference, indicated the federal government was open to negotiating separate pharmacare deals with each province.

Ms. Smith views Mr. Trudeau’s government, especially Environment Minister Steven Guilbeault, as a threat to Alberta’s prosperity and autonomy. This rocky relationship has defined her 17 months as Premier, but on Wednesday, both sides hinted they may be able to negotiate a compromise over drug coverage, similar to how Alberta and Ottawa came to an agreement on daycare funding.

The federal NDP demanded the Liberals implement a national pharmacare program in order to keep their supply-and-confidence agreement alive. The two parties reached a deal at the end of February, which is expected to cost the federal government roughly $1.5-billion annually.

Alberta and Quebec immediately said they wanted to opt out of the plan. Health care falls under provincial jurisdiction, although the federal government doles out billions in funding.

Roughly 76 per cent of Albertans have some form of drug coverage, through private insurance, Alberta Blue Cross or government programs such as those for seniors or severely handicapped residents, Ms. Smith said.

“The area that we need to work on is the number of Albertans that aren’t covered by any plan at all,” she said Wednesday of the quarter of her province that is uninsured. Alberta’s system covers roughly 5,000 drugs, including about 50 forms of birth control and 16 types of insulin drugs, the Premier added.

The province, under the control of the United Conservative Party, wants a “comprehensive plan that covers all conditions” included in Alberta’s existing system, Ms. Smith said. Alberta would be cooperative if the federal government shared this goal, she said.

“If they want to work with us, to help in expanding our robust program that already exists, to cover more people, then we’d be happy to do that.”

Mr. Trudeau, who said he came to Calgary to promote Ottawa’s new dental program, said his government is willing to tailor the pharmacare effort to meet the needs of each province and territory.

“The federal government isn’t defining the program. We are going to sit down and work with the provinces to deliver ways that cover the gaps,” he told reporters.

While Mr. Trudeau indicated the program is flexible, he stressed Ottawa’s focus on contraception and diabetes medication.

“Our goal on pharmacare is to make sure that the gaps in coverage that exist in every province across the country get filled in those two areas.”

Alberta said last month that it wanted a per-capita payout instead of participating in a cross-country program. Quebec, which has had a drug insurance plan since 1997, also insisted on a payout.

At the time, federal NDP Leader Jagmeet Singh took issue with Alberta’s initial rejection, questioning why the province would snub a project that he said would save lives and money. Meanwhile, he said Quebec was entitled to compensation if it eschewed the new national plan.

While Ms. Smith and Mr. Trudeau adopted conciliatory tones with respect to pharmacare, they continue to feud over the federal carbon levy and Mr. Guilbeault. Ms. Smith said she told the Prime Minister that Alberta would have a better relationship with Ottawa if he removed the Environment Minister from his post.

Mr. Trudeau, however, defended Ottawa’s carbon pricing system and Mr. Guilbeault.

“If people are having trouble getting along with him, maybe they need to look at their own approach to these big issues, as opposed to looking at what he’s talking about, which is consistent with building a better future for everyone,” he said.

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