Albertans voting in a provincial referendum this fall will be asked whether people legally living and working in Alberta without permanent resident status should pay extra to use public health care and education. A yes vote on Question 4 would not create a fee, set its amount or establish exactly who would be charged. It would give Premier Danielle Smith’s United Conservative Party government political approval to develop legislation covering some temporary residents and their families.

The question asks: “Assuming that all Canadian citizens and permanent residents continue to qualify for public health care and education as they do now, do you support the Government of Alberta charging a reasonable fee or premium to individuals with a non-permanent immigration status living in Alberta for their and their family’s use of the health care and education systems?” Smith has said publicly that her government wants a yes vote. Potentially affected groups include foreign workers, international students, refugee claimants and some family members.

Smith offered her clearest indication yet of a possible health-care charge during a Sept. 23 speech to the Calgary Chamber of Commerce, where she said the government was considering $1,900 per person. “So I gave you the idea of what we’re looking at: $1,900 per person,” Smith said. The figure is not government policy, would not take effect automatically after a yes vote, and could change as the government develops legislation. Smith did not say whether it would ultimately be the amount charged.

Smith raised the figure while addressing concerns about costs to businesses that employ temporary foreign workers. “So I guess that’s the question: Is $1,900 for the business to take on that fee? Is that going to make or break your business? If it is, you’re probably hiring into a low-skilled profession,” she said. “We want those low-skilled jobs to go to youth employment. We want we have a 15 to 16 percent youth unemployment rate, and we want those kids to get the first chance.”

Her remarks concerned health care; the amount, structure and application of any fee remain undecided. The province’s referendum website says employers would not be responsible for paying a future premium or fee, despite Smith’s comments about employers taking on the cost. Calgary Chamber of Commerce President and CEO Deborah Yedlin said the effect would depend on the worker and job, and whether workers or businesses ultimately absorb the expense.

“That’s an extra cost on the worker or the business, and to be honest, that adds to the cost structure that businesses are already dealing with, as they have been rising supply chains, energy prices, etc. This is this is not necessarily going to make businesses more competitive in Alberta,” Yedlin said. Businesses hiring several temporary workers could face a larger combined expense. “Because it’s one, you know, it’s one worker, $1,900. If you need 10, it’s a bigger number.”

Yedlin said a charge could be harder for lower-paid workers to afford than for higher-paid professionals. “A low-skilled worker obviously is not going to be making the same wage as a software engineer, and so that’ll be harder for them to support that extra cost,” she said. “If you’re a software engineer, it’s a different conversation. You do have some ability to support that extra cost if you want to access services that you would like in the province.”

Kayode Southwood of the Canadian Federation of Independent Business said added costs could make Alberta less attractive to workers as businesses face labour shortages. “Anything we see from the government in the future that negatively impacts employers’ ability to bring on TFWs is going to make that shortage worse at the end of the day,” Southwood said. He disputed Smith’s suggestion that young Albertans would take jobs now filled by temporary foreign workers, citing the federation’s research.

“We found that nine out of 10, jobs, filled by TFWs youth aren’t interested in taking,” Southwood said. “And what it really boils down to is, we found that over half of Canadian youth aren’t interested in doing jobs that require them to work late night shifts, or have physical labor. And a third don’t want jobs that pay minimum wage. So there’s definitely a disconnect there between employers and, I think what some of the youth are looking for,” he said. The CFIB also found that only eight per cent of youth would consider moving to a small town or rural location to work on a farm.

Southwood said fees could leave Alberta employers at a disadvantage when competing with businesses in other provinces for the same workers. “If you’re a farm owner in Alberta and you have a TFW that now, you’re suddenly having to look at potentially paying health-care costs or education costs,” he said. “Even though the government says that employers won’t be responsible for those costs, if that farmer is competing with a farmer in Saskatchewan or in another part of Canada for that same TFW, obviously, they’re going to have to sweeten the deal,” he said. Employers might respond by offering higher compensation, costs that could then be passed on to customers. “If a lot of these businesses are going to be paying more to keep on TFWs … then there’s going to be some huge costs, I think, for the consumer,” Southwood said.

Juan Carlos, a refugee from Mexico trying to establish himself in Calgary, said wanting to contribute would not mean he could afford a new charge. “Me as a refugee, I don’t have the money to do it. Not that I don’t want to,” he said. “I’m willing to cooperate and to pay anything, but my situation or our situation is really hard at the beginning, very very hard.” If a health-care fee were imposed, he said, he might have to sell the small used car he and his son bought a few months ago. “The only kind of luxury that we have, that my son and myself have, is this little small used car that we bought a few months ago. I may need to sell it right away to have a some money just to for an emergency or to cover those fees,” he said.

The Alberta government presents the proposal as a response to rapid population growth, with more than 600,000 people added in five years, and pressure on health care, schools and other public services. The government’s referendum website says federal immigration policies “almost doubled, and then more than tripled,” the number of newcomers over the past decade, and attributes pressure on public services to that increase. It describes Question 4 as asking whether temporary residents should pay tuition or health-care premiums while their status remains temporary.

The province says permanent residents would not be affected and emergency health care would continue. It also says the Canada Health Act does not require provincial plans to insure temporary residents. Existing coverage varies: foreign workers can qualify for Alberta coverage if they meet residency requirements and have an eligible work permit, while international students can qualify under certain conditions. Refugee claimants generally receive federal coverage through the Interim Federal Health Program while awaiting a decision. The referendum question does not spell out how a future Alberta law would treat these existing categories.

In a written response to CTV News, Smith’s press secretary, Sam Blackett, said the questions would have broad reach. “Questions 2 through 4 would apply to all those who are not Canadian citizens and those who do not have permanent resident status,” Blackett wrote. “The details of new legislation to implement the will of Albertans as expressed in the referendum, including the amount of any premium or fee, will be decided by the legislature thereafter,” he said.

The province estimates that 47,389 students have temporary resident status and that education costs average about $12,000 per student. It also estimates temporary workers and international students account for 1.27 per cent of Alberta’s annual health spending, or just over $400 million. The government has not said whether people already living in Alberta with temporary status would be charged or grandfathered into the existing system.

“We have to talk about that as a as a cabinet. I want to see if we even have a mandate to do it,” Smith said. Finance Minister Jeremy Nixon said significant consultation would be needed before the government could decide. “I don’t think it’s possible to answer at the moment. We would need clear instructions from Albertans, which we’re asking for during this referendum, and from there we will begin the process to implement it,” Nixon said.

Nixon said legislation would be required and he did not expect full implementation until after the 2027 election, though details could be announced earlier. Smith suggested an implementation period could reduce the number of current temporary residents affected as some workers and students leave when their permits expire. “And so if it’s going to take about a year for implementation, I would imagine that’s going to limit the number of people who will be directly impacted, and those who are coming will know what the new rules are,” Smith said.

Critics have also questioned what could happen if people cannot afford a health-care fee, including whether they might delay seeking medical care. Noha El Tanahi, settlement and financial literacy manager with the Immigra

Based on reporting by CTV News Edmonton.