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Prime Minister Justin Trudeau, seen here on Nov. 11, 2019, has a minority in Parliament, and a minority mandate in most regions.

Sean Kilpatrick/The Canadian Press

Two words illustrate the difficulties that Justin Trudeau faces in forming his minority government. They are “pipelines” and “pharmacare.”

One would normally expect to see both in the Throne Speech that will outline the priorities for Mr. Trudeau’s second term.

There’s a need to soothe frustrations in Alberta and Saskatchewan, so forcefully reaffirming Ottawa’s will to expand the Trans Mountain pipeline would be an obvious first step. But if Mr. Trudeau puts that in a Throne Speech, the NDP and the Bloc Québécois may feel obliged to vote against it, and that could bring down the Liberal government.

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Pharmacare is the NDP’s highest policy priority, so the best way for the Liberals to ensure stable support in Parliament from the New Democrats is to put an ambitious national pharmacare program on the agenda. Yet that may spark objections from Quebec’s autonomist premier, François Legault, which could then be exploited by the newly revived Bloc Québécois.

But there are ways of dealing with those challenges in the Throne Speech so that the government is not defeated in the first vote of a new Parliament. A speech is a speech, and minority governments can avoid risk by serving up skimpy word salads that, in this case, don’t mention pipelines or explain much about pharmacare.

Still, the reasons why Mr. Trudeau must choose his words carefully say a lot about his conundrum. It is not just about managing parties in Parliament. Efforts to gain the win over an opposition party may rile up a region, and efforts to ease anger in a region could lose him votes in Parliament.

That’s why Mr. Trudeau’s meetings with each opposition party leader this week are so important. It is also why he is meeting premiers, too.

Mr. Trudeau has a double minority. A minority in Parliament, and a minority mandate in most regions. The Liberals won a majority of seats in Ontario and Atlantic Canada – but not in Quebec, the Prairies, or British Columbia.

That doesn’t change their status in Parliament. And it’s not unusual that a minority government has little representation in some regions. But this is different. This minority PM faces boiling anger in one part of the country (Alberta and Saskatchewan) and a popular autonomist government in another (Quebec). As Laval University political science professor Éric Montigny noted, there is a rare common front of autonomist provinces facing an interventionist, minority federal government.

Mr. Trudeau interpreted the results of October’s election as a mandate for an interventionist government and action on climate change. The Liberals, the NDP and the Green Party all put forward interventionist platforms that talked to varying degrees about expanding social programs including pharmacare. You can bet that NDP Leader Jagmeet Singh will call for a pharmacare plan as his party’s priority when he meets Mr. Trudeau on Thursday.

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But pharmacare, like a lot of other things on the interventionist agenda, is in provincial jurisdiction.

Mr. Legault would probably raise objections about a major new federal program in the provincial domain, unless Quebec can opt out and take money instead.

There’s something else: Alberta Premier Jason Kenney may join Mr. Legault in demanding to opt out. He is surfing separatist sentiment, and just floated autonomist proposals such as creating a provincial tax agency and police force. “There is an autonomist front taking shape,” Mr. Montigny said. It is a major obstacle for Mr. Trudeau’s agenda.

And then there’s the flip side. Mr. Trudeau could move to address the frustration in Alberta and Saskatchewan and put his government in a precarious position in Parliament. He will push Trans Mountain. But he could, in theory, go further by negotiating acceptance of Alberta’s own industrial carbon tax plan, or by amending Bill C-69, which revamps reviews of major projects such as pipelines. But he probably still wouldn’t satisfy Alberta, or quell Conservative criticism, and in the process, he’d have the Greens, NDP and Bloc screaming about climate betrayal.

In Parliament, Mr. Trudeau has what is called a stable minority, with an opposition in no shape for a quick election – but the double minority situation he is in will make advancing his Liberal agenda tricky.

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