Question Period Note: DENTAL CARE

• Budget 2022 provides funding to Health Canada to provide dental care for some Canadians.

• While most Canadians have dental coverage through their employment health plans, we know there are unmet dental care needs in Canada.
• Budget 2022 sets out the Government’s commitment to expanding dental care with funding of $5.3 billion over five years, starting this fiscal year with $1.7 billion per year ongoing, so that more Canadians can access dental care when they need it.
• We are committed to working with provinces and territories and with experts as we design our approach. Children under 12 who do not have dental coverage will be the first to have access to the program, starting in 2022.

The Liberal Party of Canada and NDP’s supply and confidence agreement committed to launching a national dental care program. The agreement identified “launching a new dental care program for low-income Canadians” as the first priority action under the health care stream of the agreement. The program is restricted to families with an income of less than $90,000 annually, with no co-pays for anyone earning under $70,000 annually. The program is to start with those under 12 in this year, expand to those under 18, seniors, and persons with disabilities in 2023, then full implementation by 2025.

This commitment to a national dental care program is reminiscent of the NDP’s Motion M-62: Federal Dental Care Plan in 2021 and the NDP’s “denticare” platform commitment from the 2019 federal election campaign.

The 2019 Speech from the Throne and the 2019 Minister of Health Mandate Letter committed the Government to “work with Parliament to study and analyze the possibility of national dental care.” In February 2020, the House of Commons Standing Committee on Health (HESA) agreed to undertake a study on the development of a national dental care program, although the study did not begin before Parliament was prorogued in August 2020 and HESA has not pursued the idea since.

In October 2020, the Parliamentary Budget Officer published a cost estimate of a federal dental care program for uninsured Canadians with a total household income below $90,000. It is estimated that this program would cost close to $11 billion over five years (a one-time upfront cost of around $3 billion to clear accumulated care needs, plus ongoing program costs of around $1.5 billion annually through 2024-25). The program was estimated to benefit close to 6.5 million Canadians in the first year, and decrease to 6.3 million by 2025 due to changes in population and labour market conditions.

Budget 2022
Budget 2022 proposes to provide funding of $5.3 billion over five years and $1.7 billion ongoing. The $5.3 billion over 5 years is broken out as: $300 million in 2022-23, $600 million in 2023-24, $1.2 billion in 2024-25, $1.5 billion in 2025-26, and $1.7 billion in 2026-27.

Current Dental Care Programs in Canada
According to the Canadian Institute for Health Information, $15.9 billion was spent on dental services in 2018: 55% was covered through private insurance; 39% was paid out-of-pocket; and 6% was publicly funded. About two-thirds of Canadians receive dental coverage through employment-based private health insurance plans.

Provinces and territories (PTs) provide emergency, in-hospital medically necessary dental care for all residents. Additional PT programs vary in eligibility and coverage, and are limited to select services for groups such as those with low incomes, people with disabilities, children, and seniors.

Federal support for dental care includes:
• The federal government provides recognized First Nations and Inuit with dental coverage for services not available under other FPT programs. The Government also provides dental services to Canadian Armed Forces personnel, inmates in federal penitentiaries, and some veterans and refugee claimants.
• Federal public servants are provided with dental coverage through the Government of Canada’s employee benefits program.
• The Canada Health Transfer is providing $41.9 billion to the provinces and territories in 2020-21, which is used to support health services (including PT dental programs if they choose).
• The federal government supports Canadians with private health insurance by not including the value of these insurance plans in the taxable income of employees. In addition, the income tax system provides assistance through the Medical Expenses Tax Credit, and through a refundable medical expenses supplement available for working individuals with low-incomes and high medical expenses.

Comprehensive data does not exist on unmet dental care needs at a national level in Canada. A campaign led by the Canadian Association of Public Health Dentistry suggests that 1 in 5 people (6 million Canadians) are not receiving needed dental care due to cost, and that only Canadians with financial resources or insurance can experience good oral health.

According to the Canadian Dental Association, an estimated 2.26 million school days are missed each year due to dental-related illness, and tooth decay accounts for one-third of all day surgeries performed on children between the ages of one and five in Canada. As well, much of the burden of dental disease is concentrated in disadvantaged children: those from low-income families; Indigenous children; new immigrants; and children with special health care needs.

KEY FACTS
• Budget 2022 confirmed the Government’s commitment to expanding dental care with funding of $5.3 billion over five years, starting this fiscal year with $1.7 billion per year ongoing, so that more Canadians can access dental care when they need it.
• This plan will start with under 12-year-olds in 2022, and then expand to under 18-year-olds, seniors, and persons with disabilities in 2023, with full implementation by 2025. The program would be restricted to families with an income of less than $90,000 annually, with no co-pays for those under $70,000 annually in income.
• According to the Canadian Institute for Health Information, $15.9 billion was spent on dental services in 2018: 55% was covered through private insurance; 39% was paid out-of-pocket; and 6% was publicly funded. About two-thirds of Canadians receive dental coverage through employment-based private health insurance plans but there are an estimated 10 million Canadians without access to insurance that meets their dental needs.