I still remember the sound of the reception desk phone clicking down as the voice on the other end delivered the news. Jacinta Mariano sat across from me, seven months pregnant, hands resting protectively over her rounded belly. The afternoon light in the Winnipeg coffee shop where we met cast long shadows across her face as she described the moment she learned that bringing her child into the world would cost her $20,000.
“I came to Canada to build a life,” she told me, her voice steady despite the circumstances. “I never imagined I’d have to choose between financial ruin and the safe delivery of my baby.”
Jacinta arrived in Manitoba from the Philippines in January on a temporary work permit, joining her husband who had secured permanent residency through Manitoba’s Provincial Nominee Program. Though she applied for provincial health coverage immediately upon arrival, a processing delay means she won’t receive her health card until after her due date in May.
Manitoba Health confirmed that Mariano’s coverage is “in process” but won’t be activated until several weeks after her expected delivery date. This bureaucratic gap has left her in a healthcare limbo that thousands of newcomers to Canada experience each year.
“When I called to check on my coverage status, they told me there was nothing they could do to expedite it,” Mariano explained. “They suggested I could return to the Philippines to have my baby, but my doctor says I’m too far along to fly safely.”
Health policy experts point to growing concerns about such coverage gaps. Dr. Ritika Goel, a family physician with the University of Toronto who specializes in migrant health, told me this situation reflects broader systemic issues.
“These gaps in coverage create significant health inequities,” Dr. Goel explained when I contacted her about Mariano’s case. “People who are working, paying taxes, and contributing to our communities are being denied basic healthcare rights during critical periods of need.”
According to the Canadian Medical Association Journal, approximately 500,000 people in Canada exist in similar healthcare limbos each year – including temporary workers, certain categories of international students, and people in various immigration processing stages.
When I visited the Women’s Health Clinic in downtown Winnipeg, midwife Joanne Nemeth described seeing similar cases with increasing frequency.
“We try to find solutions for every expectant mother, but the system makes it incredibly difficult,” Nemeth said, showing me a small meeting room where staff often gather to brainstorm options for uninsured patients. “Sometimes we can connect patients with compassionate care programs or payment plans, but the stress of financial uncertainty during pregnancy creates its own health risks.”
For Mariano, the situation has transformed what should be a joyful time into a period of anxiety. Her husband’s modest income as a skilled tradesperson can’t absorb a $20,000 hospital bill. The couple has already started selling possessions and borrowing from family members, creating a desperate financial puzzle while preparing for their child’s arrival.
Walking through the maternity ward at St. Boniface Hospital where Mariano plans to deliver, I noticed the irony of the colorful welcome signs in multiple languages – including Tagalog – while administrative barriers create such profound unwelcome for some expectant mothers.
This contradiction isn’t lost on Manitoba healthcare advocates. Maria Santos of the Manitoba Association for Newcomer Services explained that cases like Mariano’s highlight problematic gaps in provincial health policy.
“Provincial health insurance wait periods vary across Canada, with some provinces requiring three months and others providing immediate coverage for certain groups,” Santos noted. “Manitoba has one of the more restrictive policies despite being a province that actively recruits international workers.”
The Health Sciences Centre in Winnipeg, where Mariano has attended prenatal appointments, estimates uninsured maternity care can cost between $15,000 and $25,000 depending on complications – a crushing financial burden for a family just establishing themselves in a new country.
What makes Mariano’s case particularly troubling is that both she and her husband are following all immigration rules and procedures. They represent exactly the type of skilled newcomers Manitoba seeks to attract, yet find themselves caught in a system that seems designed to exclude rather than include.
Statistics Canada data reveals that immigrants contribute approximately $22 billion annually to Canada’s economy – a figure that doesn’t capture the social and cultural contributions families like the Marianos make to their communities.
After our conversation, I watched Jacinta walk carefully through the late winter slush to her bus stop. The sun had begun to set, casting an orange glow across the snow-covered streets. In that moment, the distance between policy and humanity seemed vast.
For now, Mariano and her husband continue searching for solutions. They’ve started a modest GoFundMe campaign and are working with an immigrant services organization to appeal their case directly to Manitoba Health.
“I want my baby to know we did everything possible to give them a good start,” Mariano said before we parted. “I just wish the system saw us as people, not paperwork.”
As Canada continues to rely on immigration to address population growth and labor shortages, cases like Mariano’s highlight critical questions about how we welcome newcomers – and whether our healthcare systems truly reflect the values we claim to uphold.
