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Missing teeth: Who’s left out of Canada’s dental care plan

Uninsured seniors aged 87 and up can start applying for dental care this month under the Canadian government’s new Dental Care Plan. (Courtesy: Canva)

Canada is expanding public health coverage to dental care—but it’s not universal.

Executive summary

As part of the March 2022 Liberal-NDP Supply and Confidence Agreement, the federal government is creating a national public dental care plan—the most significant expansion of public health care in decades. This new plan holds the potential to fill a tremendous need: An estimated 12.9 million Canadians do not have dental insurance (either public or private); 1.2 million of them are children under the age of 12. However, this analysis shows that the current dental plan will fall far short of the need.

This new federal insurance plan is unfolding over three distinct phases between 2022 and 2025. No matter the phase, only families making under $90,000 will be able to access the insurance, creating a real barrier to access dental services.

A family income of $90,000 annually for families with children isn’t unusual in Canada: 59 per cent of families with children made over $90,000 in 2019, amounting to 2.2 million families. Earning $45,000 for each parent isn’t a tremendous salary in Canada. But making more than that precludes those families from receiving federal dental care coverage.

The first phase, underway through to June 2024, is called the Canada Dental Benefit (CDB). It’s a cash transfer of $1,300 a child if that child sees a dentist; 65 per cent of children under 12 without other dental insurance—794,000 young children—could get the $1,300 transfer. 382,000 young children have actually received support so far. However, 35 per cent—426,000 young children—without dental insurance cannot access it because their families make over $90,000.

In phases two and three, the dental plan changes from cash transfers to an actual insurance plan and expansion of Canadians who are eligible for the plan.

Phase two, now named the Canada Dental Care Plan (CDCP), is actual insurance. This second phase covers not just young children, but any children under 18, seniors and people with disabilities. It has just started in 2024.

In phase three, the only eligibility restriction is the $90,000 family income cap and the lack of other dental insurance. Phase three of the CDCP will cover 8.5 million people but will leave another 4.4 million out of the plan due to the income restriction. A further 1.4 million people might have their inadequate provincial public dental insurance supplemented by the new federal plan. Upon full implementation, 9.8 million people will either gain dental insurance or have it supplemented by the CDCP.

It would cost an estimated $1.45 billion on top of the $3.3 billion presently budgeted for the 2025-26 year to include the people without dental insurance who won’t qualify for the CDCP.

The choice is two-fold: (1) Continue to create new medical care programs with a fill-in-the-gaps model and an income cap, like Canada is currently doing on dental care, or (2) Align new medical care programs with the principles of the Canada Health Act, which is based on the underlying principle of health care for all.

The findings in this analysis of Canada’s nascent national dental care plan might also be relevant to the much anticipated announcement of a national pharmacare plan. Income restrictions could leave millions of Canadians out of both plans while a universal program would align with the principles of the Canada Health Act—everyone should be eligible for these programs.

Download this report: https://monitormag.ca/dist/documents/missing-teeth-2024.pdf

Chapters

David Macdonald (he/him) is a senior economist with the Canadian Centre for Policy Alternatives.

 

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