At a Calgary Chamber of Commerce event, Premier Danielle Smith said the government is looking at charging between $1,400 and $1,900 per person, citing the $1,900 figure as an example modelled on the United Kingdom’s immigration health surcharge. Smith framed it as part of the October 19 referendum questions, one of which asks whether Alberta should charge a “reasonable fee or premium” to people with non-permanent immigration status for use of the public healthcare and education systems.

Critics of the plan argue that imposing a specific annual premium only on one category of residents (those with non-permanent status) while others pay only through general taxes would break the “uniform terms” requirement in the Canada Health Act and create two classes of insured people.

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The Canada Health Act does not explicitly require provinces to cover every temporary resident. Ontario and Manitoba already exclude most international students from their provincial plans, for example. Even a CBC explainer covering the referendum had to admit that fact.

Canadian healthcare has never been “universal” in the sense that every newcomer is instantly and identically covered. Waiting periods, permit-length requirements, and outright exclusions for certain temporary categories already exist across the country. The referendum proposal would simply draw a clearer line between two groups the law already distinguishes: people who have made a long-term commitment to Alberta (citizens and permanent residents) and people whose legal status is time-limited.

There is no mandate federally or provincially that obligates provinces to cover healthcare for temporary visitors.

Health care premiums themselves don’t violate the Canada Health Act either. Albertans all had to pay monthly premiums for healthcare until 2009.