Counties with existing dental coverage received a smaller share of federal child support

Provinces that already cover dental care for children have been getting a smaller share of federal dollars from the Canada Dental Benefit, raising concerns that governments will end that coverage as the program expands.

Data provided to Congress shows that counties and territories with dental benefits for all children received less federal money relative to the size of their populations than counties that only provide targeted coverage.

The federal dental benefit was launched last fall and is intended to provide cash payments to low- and middle-income families without private insurance. Children qualify for $260, $390, or $650, depending on their household income.

Prince Edward Island, Nunavut, Newfoundland and Labrador, Quebec, Nova Scotia and Yukon all cover at least basic dental care for children – and received less money than the national average.

Health Canada said the benefit was intended to supplement provincial coverage, which is not applied equally across the country.

Results suggest ‘injustice’, says MP

The data may confirm that the program is working as intended to fill gaps in coverage, but the Bloc Québécois said the results reveal an “injustice”.

“We have a situation where those counties that have higher taxes, whose citizens contribute more to their own dental plans, are in a situation where they’re less covered by the federal program and they’re subsidizing the dental program in other counties,” said Bloc MP Jean-Denis Garon.

He said the federal program is a “strong deterrent” to counties from launching progressive programs.

The only other counties to fall below the national average were British Columbia and New Brunswick.

People in Yukon, which has one of the most generous pediatric dental programs in the country, received the least amount of benefits at $1.02 per person.

Manitoba brought in the most money with the benefit, $5.77 per person. That province offers targeted coverage, such as preventive care for at-risk families and basic care for children under the age of 18 from low-income families without private insurance.

Available data includes benefits provided to 271,790 children from the program’s inception last fall through April 27. The number of children who have received the Canada Dental Benefit has since passed 300,000.

Population data is based on Statistics Canada estimates from the first quarter of 2023.

The Liberals initially promised a dental care program by the end of 2022 as part of their trust and supply agreement with the NDP.

When they failed to meet that deadline, the government instead launched a temporary benefit for children from middle-income families while they work on a permanent programme.

Plans to expand program

The Liberals now hope to launch a $13 billion federal dental insurance plan by the end of the year that would cover children under 18, seniors and people with disabilities, with plans to expand further in the coming years.

The insurance plan would be available to eligible people with household incomes less than $90,000 and no private insurance. People who receive provincial coverage are still eligible.

“If you were a provincial government, why not take a step to de-insure your people and send them to the federal plan?” said Colleen Flood, a research chair in health law and policy at the University of Ottawa.

“That would probably make sense from a tax perspective.”

Quebec has already asked to opt out of the program and instead raise $3 billion over five years to supplement its own dental care programs.

Federal Health Minister Jean-Yves Duclos said he is open to negotiations with the province, but has not said whether it will be allowed to waive.

In a statement, Health Canada said provinces and territories are working with the federal government on its dental care plans.

For example, all 13 provinces and territories have agreed that the Canada Dental Benefit will not be considered income when people apply for other social assistance and means tested programs.

“We continue to work with stakeholders and partners, including provinces and territories, to improve access and ensure that eligible Canadians receive the care they need,” said Health Canada’s statement.

Flood applauded the government for taking a step forward to address gaps in dental care, saying such progress would likely not have been achieved without pressure from the NDP.

“I actually think this is fantastic, but nonetheless they should start doing all the other kind of background work to have a more sustainable, sustainable, better thought out dental health plan — not just insurance,” she said.

In a recently published article by the Institute for Research on Public Policy, Flood and several colleagues suggest that the federal government’s decision to launch a standalone program rather than negotiate with counties is unlikely to be enough to ensure everyone has coverage has.

“You really need a joint federal-provincial approach,” she said.

The group of policy experts argued that the long-term plan should involve all government procurement and an independent agency charged with administering the insurance plan, drafting associated regulations and collecting oral health data.

They also recommend pushing for a universal dental care plan for reasons of fairness and efficiency, rather than the means-tested approach the government has committed to so far.

The Liberals are expected to launch the first phase of the dental insurance plan by the end of the year.