The federal government is increasing funding for its national dental care plan as it is projecting the program will provide coverage to millions more uninsured Canadians than had previously been estimated.
The Canadian Dental Care Plan was first announced in Budget 2022, the end result of a confidence-and-supply-agreement that saw the Liberal minority government agree to implement the longstanding NDP policy proposal.
Described as a “down payment” on the longer-term goal of establishing universal dental care in Canada’s publicly-funded health care system, the means-tested plan aimed to address an urgent need by providing dental coverage to millions of uninsured families with household incomes under $90,000.
The 2023 Budget announces $13 billion in funding over five years for the Canadian Dental Care Plan — a $7.3 billion increase from when it was first announced in 2022.
Finance Canada officials said the increased funding was in response to “new information” that led to adjustments in their original estimates. While department officials declined to specify what that information was, they noted the plan will now cover up to “nine million uninsured Canadians.”
That’s 2.5 million more uninsured Canadians than previously cited in a cost estimate conducted by the Parliamentary Budget Office in 2020.
“Around 6.5 million Canadians (82% of the eligible population) are expected
to benefit from the proposed federal program in 2021,” the PBO stated, adding that “the number of beneficiaries is expected to reach to 6.3 million by 2025, due to changes in population age distribution and improved labour market conditions.”
During the 2019 federal election, the NDP had originally estimated its plan would cover 4.3 million uninsured Canadians.
Experts working on the file say it’s not surprising the federal government discovered the scope of Canada’s dental care problem is even bigger than previously estimated given a widespread lack of data on the issue.
“I think they’re right when they say they got more information,” Jacquie Maund of the Ontario Oral Health Alliance said.
“There was really not a lot of expertise or knowledge at the federal level around access to dental care,” Maund said. “They’ve done a lot of learning and realize that it’s more complicated.”
“Because of this political agreement, the federal civil servants in the health ministry have had a steep learning curve … They now understand much better how the dental industry works in Canada and costs associated with envisaging a public plan that would be available to people who don’t have dental insurance.”
The 2023 Budget acknowledges the federal government encountered problems understanding the scope of the problem, noting that “existing data on oral health in Canada is limited and cannot be disaggregated by region or socio-economic characteristics.”
The 2023 Budget announces $23.1 million over two years to let Statistics Canada collect data on oral health and access to dental care in Canada.
The 2022 Budget included an impacts analysis that found the dental care plan would benefit low-income Canadians, youth and women the most, while filling an urgent need for remote and rural Indigenous communities.
“Low-income Canadians have both the highest level of oral health problems and the most difficulty accessing oral health care,” the report notes. “Women (24.1 per cent) were more likely than men (20.6 per cent) to report cost as a barrier. Canadians aged 18 to 34 (28.3 per cent) were the age group most likely to report cost as a barrier to dental care.”
The analysis also noted “Canadians living in rural and remote areas face greater challenges accessing care due to lack of availability,” while “Indigenous peoples suffer from some of the highest oral disease rates in Canada.”
The federal government is allocating $250 million over three years, and $75 million ongoing, to establish an Oral Health Access Fund for “targeted measures” to address “oral health gaps among vulnerable populations and reducing barriers to accessing dental care, including in rural and remote communities.”
However, Finance Canada says those “targeted measures” remain “to be determined.”
An internal Health Canada report obtained highlighted that Indigenous populations in rural and remote communities often face barriers to accessing dental care since “care is often not available due to issues unrelated to cost.”
Maund says two barriers to accessing dental care in rural and remote communities include challenges with transportation and the supply of dentists.
“Transportation is a key issue that we hear again and again,” Maund said. “They can’t get to the dentist if they have serious requirements because they don’t have those services available in rural communities.”
In addition to providing or subsidizing transportation, some northern communities could have “fly-in dentists” that spend “one day at the community hall and see a number of people.”
Overall, Maund says it is “encouraging” that the federal government is making a “long-term permanent commitment” to dental care and “showing sensitivity to the fact that you can’t have a one-size-fits-all program when you’re dealing with vulnerable people and people in remote communities.”