The Alberta government is asking voters to weigh in on whether some temporary residents in the province should no longer have access to health care, education and social services. It’s the second question on October’s referendum ballot — one that’s been largely dominated by talk about question 10, whether to proceed with a separation vote — that some experts say can be confusing and some advocacy groups say is concerning. Immigration has been driving Alberta’s booming population, the premier has said, and it is pushing the health and education system to its brink. “Temporary individuals should be treated as that: temporary and tourists,” Premier Danielle Smith said in February, right after announcing the province-wide referendum. First, the question: Do you support the Government of Alberta introducing a law mandating that only Canadian citizens, permanent residents and individuals with an Alberta-approved immigration status will be eligible for provincially-funded programs, such as health care, education and other social services? “It’s not quite clear to me — even as somebody with a legal training — what that referendum question is actually asking,” said Yin Yuan Chen, an associate professor at University of Ottawa’s Faculty of Law who specializes in migrant and health law. The question doesn’t fully explain what the consequences would be for temporary residents if the proposal moved forward, Chen told CTV News. It also doesn’t define what an ‘Alberta-approved immigration status’ is. On the Alberta government’s referendum website, the FAQ section says the province will eventually define that term by working “with employers and other groups to develop a system where we determine the workers our economy actually needs.” “There’s a potential that any kind of exclusion introduced by the government could run afoul of the (Canadian) Charter’s guarantee of equality,” said Chen. “I think that is an important point for people to know ahead of time that there is a potential risk. But, again, without defining the term, we don’t know whether that risk actually exists,” he added. What could happen? If the government moves ahead with the proposal, it could have chilling impacts to both public health as a whole and to migrants’ willingness to come to Alberta in the future, some experts and advocates say. “Cutting health care for a group of people in society is never a net benefit to either those individuals or to society as a whole or to the taxpayer,” said Dr. Annalee Coakley, the co-director of the Migration Humanitarian Health Collective. Limiting or denying health-care access to some residents “will create a huge underclass or subclass” in the province, added Coakley, who is also a clinical assistant professor at the University of Calgary’s Cumming School of Medicine. “It means we’re heading much more into an American-style system, where there’s a large group of people where they’re simply unable to access care, and their health deteriorates, their ability to contribute to society declines,” she said. According to Statistics Canada, Alberta has 279,477 total non-permanent residents, as of July 2026. Some, such as refugee claimants or protected persons, have their short-term health-care costs covered by the Interim Federal Health Program, not the province’s. Excluding those federally covered individuals, Alberta has around 246,000 temporary residents, with the vast majority of them holding either work permits, study permits or both. Just over 40,000 of them are international students. “We’re not supportive of this (proposal),” said Gabriela Dziegielewska, the University of Calgary’s Students’ Union President. “Without access to public health care, international students are going to forgo preventative care. They’re not going to see their primary doctor, and instead, their health issues are just going to be faster and faster until they land in already-overcrowded emergency rooms. That’s not good for them. That’s not good for the province writ at large,” she added. In addition to that, Dziegielewska said, international students already pay higher tuition fees. “They pay far beyond their fair share, and they’re worried that they’re now going to be treated as cash cows for the health-care system as well.” The cost According to the Government of Alberta, temporary residents pay about $150 million in taxes to the province every year, but the cost for their health care, education and social services is estimated at a billion dollars annually. “That math doesn’t math,” Premier Smith told a crowd of business leaders on Sept. 23. “We’ve got to make those things match. We’ve got to make sure that the jobs are available for Alberta workers first, Canadian workers first.” “The priority (needs to be) on making sure that we’ve got the support for our health-care programs and our education for our permanent taxpayers,” Smith said. Her government is seeking the mandate to move forward on some of these changes, the Premier explained, but we likely won’t see them happen very quickly. Finance Minister Jason Nixon said any changes, should Albertans want them, aren’t likely to be fully implemented until after the next provincial election in 2027.
