Expected to be fully implemented by May of 2024, the new Canadian Dental Care Plan is designed to increase access to dental care for all Canadians. Recent discussions highlight a significant issue known as the “marriage penalty,” which potentially discriminates against couples when determining eligibility for this essential health service. University of New Brunswick law professor Kerri Froc has expressed her concerns with the plan’s means-testing focus. She thinks that it could disproportionately punish people in spousal relationships, as one partner must earn above the threshold to avoid punishment.
Due to the current regulatory structure, only people that make $90,000 or less per year are eligible to apply for coverage. Yet, if they are married or in common-law partnerships, their combined income may disqualify them from receiving benefits, even if their financial situation resembles that of two single individuals earning $50,000 each. This configuration invites scrutiny from an equity and fairness perspective in accessing minimum required dental care.
Starting in May 2024, more than four million Canadians will have been approved for services under Canada’s new Canadian Dental Care Plan. The program strongly favors families making under $70,000. Families making from $70,000 to $90,000 get limited help, with gradations of support between those levels. These work supports are critical for low-income working families. These measures create challenges for couples that want to increase their household earnings. Once they break this $90,000 barrier, their ability to continue to get essential dental services disappears.
Impact of Means Testing
This means-testing approach used on the Canadian Dental Care Plan has been widely condemned by a number of experts. Steven Staples, the national director at the Canadian Health Coalition, argues that means testing inherently raises concerns about fairness in access to healthcare services. He doesn’t think whether someone gets quality, timely health care should depend on income. Nobody should go broke when they get ill, no matter their income level.
“Means testing, on the basis of principle, is concerning.” – Steven Staples
Froc finds himself questioning the policy’s ability to reflect the varied financial realities families face. She explains the proposal fails to address real-world, individual occurrences such as disabilities or alternate family structures. These five factors can dramatically impact the cost of care.
“For adults with disabilities, they have different costs… but there are none of those exceptions in the plan now.” – Anonymous government representative
As Froc clearly illustrates, most government benefits are dependent on family income. This strategy can, albeit inadvertently, punish pairs who are working to build up their fiscal situations.
“Many government benefits look at family income…,” – Kerri Froc
Furthermore, she notes that the assumption behind the policy—that couples earning above $90,000 can afford dental care—may not reflect reality for many households.
“The assumption is [if your household earns] more than $90,000 you can afford your dental care.” – John Stapleton
The Debate Over Family Status
The debate around the marriage penalty goes deeper into social justice and equity issues related to marital status and income pooling. Froc makes the case that many policies apply spousal relationships when determining income. He poses a larger and more fundamental question — in this context, is family status even protected?
“It’s an open question as to whether family status is even protected.” – Kerri Froc
Finally, she disputes the popular conception that couples naturally have greater financial means available to them compared to single people. This perspective can do a disservice by ignoring particularly how much a household and kids can cost and differ.
“It shouldn’t matter how much you earn [to receive health care],” – Steven Staples
Further, as Stapleton points out, people don’t usually choose to get into a relationship because of promised health care. He thinks policies can do more to open doors for committed couples who want to climb the economic ladder together. It’s time that they began to advocate for the communities they represent directly.
“I don’t think you’d decide to be a single or a couple based on what you’re going to get for dental,” – John Stapleton
Looking Ahead: Potential Changes
The marriage penalty in the Canadian Dental Care Plan continues to be an active area of advocacy. Economists and urban planners alike are encouraging policymakers to think big with their reforms. Froc highlights that we’re missing the boat on addressing family income in a more nuanced way that better reflects the reality of how income affects healthcare access.
“It’s something that is worth looking at in the bigger picture,” – Kerri Froc
She says it’s problematic that the system as it exists today doesn’t recognize the way households are made up today. These dynamics and financial burdens can have a profound toll on a family’s access to dental care. By correcting for these shortcomings, we can put forward a fairer process. This will allow all Canadians, including racialized and marginalized populations, to access dental services without experiencing discrimination.
