'Caught between 2 bureaucracies': Why this pregnant Alberta nurse may have to pay for her health care

Justine Friedlander is a registered nurseproviding care to Albertans, but soon some of those services could cost her thousands.

The 29-year-oldworksat a long-term care facility inHanna, which is a roughly two hour drive northeast of Calgary.

She's been informed by the province's health body thatshe'll be without health insuranceas of Nov. 23 unless something changes quickly with her permanent resident application with Immigration, Refugees and Citizenship Canada (IRCC).

The nurse, originally from Northern Ireland, is 6 months pregnant and has implied status meaningshe's legally allowed to work in Alberta.

She estimates the cost to deliver her baby due in Februarywill bean "astronomical" $15,000 without provincial health insurance.

And if she contracts COVID-19 at work, she'd be on the hook for any necessary medical costs too.

"That's a kick in the teeth. At the end of the day, I signed up to be a nurse and I know that comes with risks And[Alberta Health] sent me a letter back saying, 'You will be responsible for any charges that you incur if you require health care, and have a good day,'" Friedlander said.

"It's a little bit of a bite, to say the least," she added.

Pandemic processing delays at Immigration Canada

Friedlander met her Canadian fianctravelling abroad, and moved to Canada in 2019 to be with him. She applied for permanent resident status in Canada in May 2021. Her Immigration Canada file has been confirmed as opened, but it has not moved past that point. The federal body has previously said it's been experiencing processing delays due to the pandemic.

Friedlander was given two extensions to her health care.

The first was the one-time 90-day extension. She was issued a second 90-day extension after her MP, Martin Shields, advocated to the province on her behalf.

"They made it incredibly clear that this was not normal. This is a gesture of goodwill and not to expect that again," she said.

CBC has obtained the letter from Shields and other documentation which shows Friedlander's permanent resident status application, registered nurse status with AHS, and a letter from Alberta Health where she was informed she will not receive any further health insurance until her immigration file is moved forward.

Friedlander has considered going back to Ireland to deliver her baby, but there's a catch there too. It would invalidate her Immigration Canada applications, and take a rural Alberta nurse out of actionat a time when hospitals are critically understaffed.

"I feel so negatively about this situation that if I left [to go to Ireland], I don't know if I'd want to come back at all," she said.

"My fiancand I, this is our first baby. We don't want to be on the other side of the world. It's a really sad situation."

She wants Alberta Health to review the policy on how it decides what the health insurance extension period is.

Looking for 'some degree of human compassion'

Calgary immigration lawyerPeter Wongsays Alberta Health needs to be cognizant of Immigration Canada delays, and extend its policy for longer than it ordinarily would.

"The nurse is caught in between two bureaucracies and really doesn't have a way out," Wong said.

"What is the policy reason why a foreign worker in Canada particularly one that's on the COVID-19 frontlines, particularly one that's pregnant what's the rationale for not extending it a third time?"

Wong says it's possible Alberta Health will backfill the costs if Friedlander's permanent resident status is approved, but that's not guaranteed.

He also says Friedlander is not the only person in this sticky situation, as there are thousands of people living in Alberta facing Immigration Canada delays, and many of them without health insurance.

"This is a situation where as long as bureaucracies, provincial and federal, have some degree of human compassion, these are practical solutions that they can solve," Wong said.

Alberta Health says private insurance an option

Alberta's publicly-funded insured health services are only available to eligible residents, as defined by the Canada Health Act, a spokesperson from Alberta Health said.

The spokesperson said the requirements for legal status to be in and remain in Canada are set by the federal government.

"Alberta has historically been more accommodating of temporary residents than most other provinces in providing health-care coverage," the spokesperson said in an emailed statement.

"We have adjusted as required over the past 18 months. For example, earlier in the pandemic, when the federal government experienced delays in responding to applications for extension of work permits, we extended our health-care coverage to those individuals awaiting renewal of their work permits beyond the usual limit of 90 days past the expiration date of their permit," the spokesperson said.

Alberta Health says Immigration Canada processing times have returned to normal, and they have already provided extensions of health insurance of up to six months for some.

"Individuals waiting for a decision from IRCC may choose to return to their home country to continue the process, or if they remain in Canada, and are no longer eligible for provincial health-care coverage, they may choose to obtain private health insurance."