IIRC that's also available in some EU countries, the issue in this specific case isn't google but the fact that devices which could be construed to offer medical info tend to require certification varying by country
https://www.businessinsider.com/stranded-man-alaska-rescued-...
I believe they currently only use Terrestar-1 and Terrestar-2, with Inmarsat to follow some time this year for almost global coverage.
Terrestar-1 covers the lower 48 US states with one spot beam, and Alaska and Hawaii with another one each, but I believe the latter two ones are relatively new, so maybe Google isn't using these yet?
I suspect this because I've used a Motorola Defy Satellite Link for the past year, which uses IoT-NTN just like the Pixel's baseband, and it's only been available in Europe and the lower 48 at launch (i.e. also with Hawaii and Alaska missing).
And this really does seem to be largely due to regulations (and probably also integration with local emergency services), as there is no geographic pattern to availability.
[1] https://en.m.wikipedia.org/wiki/Global_North_and_Global_Sout...