Ever since the 1950s, EU member states have sought to protect national competences to organize, finance and provide healthcare from integration at the European level. Despite these efforts, the EU has a become a significant player in public health, regulating key questions on the access to and delivery of healthcare in member states. In their article “The making of a European healthcare union: a federalist perspective” published in the Journal of European Public Policy, Hans Vollaard, Hester van de Bovenkamp and Dorte Sindbjerg Martinsen explain how the EU attained authority in public health against all odds, and offer an outlook on a European healthcare union in the making. Hans, Hester and Dorte show that the free movement of goods, services and workers allowed the European Commission to expand its involvement in healthcare, complemented by the Court of Justice’s favourable interpretations of EU healthcare legislation. Member states’ use of EU fora to pursue voluntary co-operations in the health sector and their willingness to delegate competences to the EU-level in exchange for financial support further facilitated the development of a European healthcare union. However, Hans, Hester and Dorte caution that this union remains fragile. While EU officials see the Europeanization of healthcare as an “instrument to foster a European sense of belonging among the citizens of the EU member states”, evidence that a European healthcare union cultivates citizens’ loyalty toward the EU appears thin at best.