Dr. Hamza Jafri, a dentist in Rankin Inlet, Nunavut, takes care of five-year-old Piujulia Taylor’s teeth in October, 2022.Fred Lum/the Globe and Mail
The federal government announced new timelines for the expansion of its national dental program on Monday, but the Canadian Dental Association says the lack of details about how the program will work is concerning many dentists.
The Canadian Dental Care Program can be accessed by families whose annual net income is less than $90,000 and who don’t have access to private insurance.
Health Minister Mark Holland said Monday that about nine million Canadians currently do not have access to dental care.
“Far too many people have avoided getting the care that they need simply because it was too expensive, and that’s why this plan is essential,” he told a news conference.
Heather Carr, president of the Canadian Dental Association, said the association has been advocating for better coverage for vulnerable individuals, including seniors and people with disabilities. “Any plan that’s going to address access to care issues for them is a positive,” she said.
But Dr. Carr said many dentists are anxious to hear more information about the program and how it will work. “The dentists don’t know how to react because they don’t know all the details.”
One key issue is how the new federal plan will align with the array of private insurance plans used by Canadians across the country, as well as the provincial and territorial plans that already exist. Experts are concerned that the federal program could undermine those plans.
Dr. Carr said the association has been advocating for Ottawa to respect existing plans, adding that she and provincial and territorial dental groups are in talks with governments across the country to hammer out details of the program.
Mr. Holland said his conversations with his provincial and territorial counterparts have been “extremely positive.”
The minister, asked about concerns that employers who offer coverage for their employees may scale back those benefits, said he’s had discussions with businesses as well as provinces “to ensure that we don’t see that displacement.” He said the government will adjust if that becomes a concern.
“We’re at a stage right now where the conversations have been very productive, where we have very solid reason to operate on the premises of limited displacement,” he said.
The Conservative Party did not respond to a request for comment on the dental announcement, nor did the party raise the issue during Monday afternoon’s Question Period.
The announcement was criticized by the Bloc Québécois as an intrusion into Quebec’s provincial jurisdiction.
“We already have a dental care system in Quebec. All they had to do with was provide the funding and we would have expanded it, but that’s too complicated for him,” Bloc MP Alain Therrien said during an exchange with Mr. Holland.
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Mr. Therrien also took issue that the government has contracted Sun Life, a private benefits provider, to deliver the program.
In a statement, Steven Staples, national director of policy and advocacy with the Canadian Health Coalition, praised the move toward more dental coverage, but said the program should be extended to all eligible individuals as soon as possible and that income and other possible barriers should be removed.
Noha Gomaa, assistant professor at the Schulich School of Medicine and Dentistry at Western University, said it’s unclear whether patients enrolled in the program will have a maximum number of services they can access.
“We really don’t know what it will look like,” she said.
But she noted that the $70,000 family-income threshold, below which individuals won’t face a co-pay, is higher than many other existing plans.
Under Ottawa’s phased-in approach, seniors aged 87 and older will be allowed to apply starting this month, followed by people 77 to 86 in January, 72 to 76 in February and those 70 to 71 in March.
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Seniors aged 65 to 69 will not be able to apply until May. Persons with a valid Disability Tax Credit certificate and children under 18 will be able to apply online as of June. All remaining Canadians who meet the income eligibility requirements will be able to apply in 2025.
The full implementation of the program will not take effect until 2025.
Canadians who have applied, qualified and are enrolled in the expanded benefit will be able to start receiving oral health care as soon as May.
The minority Liberal government agreed to roll out a national dental-care program as part of its parliamentary deal with the NDP, in which the smaller party agreed to keep the Liberals in power until 2025 in exchange for action on a list of policy issues.
NDP health critic Don Davies was part of the government’s news conference.
“It’s no exaggeration to say that this is the biggest expansion of public health care in Canada in many generations,” he said.
The Canada Dental Benefit (CDB) was first launched a year ago for children under 12.
The timeline is broadly in line with the March, 2022, agreement between the Liberals and the NDP. However, that deal said it would be expanded to seniors and persons living with a disability in 2023, while Monday’s deal means the full rollout for seniors and people with a disability will not occur until the first half of 2024.
Examples of services that will be covered under the program include preventative cleaning, examinations and X-rays, fillings, root canals, dentures and extractions.
The services will be fully covered for families with net incomes below $70,000. Families with net incomes between $70,000 and $79,999 will be required to cover 40 per cent of the cost, known as a co-pay. That co-pay rises to 60 per cent of the cost for families with incomes between $80,000 and $89,999.
The federal government’s 2023 budget said the program will cost $13-billion over five years and $4.4-billion in continuing annual funding.
The Liberal-NDP deal also calls on the government to pass a Canada Pharmacare Act by the end of 2023. No such legislation has been introduced and the House of Commons is scheduled to rise for the holidays later this week. The Liberals and the NDP have recently indicated that talks on pharmacare could continue into the new year.
“We’re having productive discussions and exploring a number of what I would call very exciting and creative possibilities to make progress towards universal national public pharmacare,” Mr. Davies said.