Federal health-care funding has long been a source of policy debate in this country, a situation exacerbated recently by the COVID-19 pandemic and the premiers’ calls for a large expansion of the Canada Health Transfer. In this article, we explore four potential pathways policy-makers might consider in order to improve federal health-care funding. These potential pathways should allow policy-makers to consider how to adapt to changing circumstances while addressing citizens’ concerns and the demands of provincial/territorial governments. We do not support one or another of these policy pathways. Instead, we explain what they are and what impact they could have.