Canada Revenue Agency Tax Cuts Disadvantage Disabled Women

According to recent media reports, (here, here) the federal government has been changing the way people living with Type 1 Diabetes (T1D) access a long-standing disability tax credit. This has resulted in a number of people who have lost benefits that once received them. This change in practice will disproportionately affect women as both caregivers and as people living with disability.

Living with Diabetes

Having diabetes is expensive and cost is one of the greatest challenges for people living with the disease. According to the Canadian Diabetes Association (CDA), 57 per cent of Canadians living with diabetes compromise their diabetes management because they can’t afford to comply with their prescribed therapies; the medications, devices and supplies needed to keep them healthy. The CDA estimates that people living with T1D incur 2-5 times more medical costs than people without diabetes. And it should come as no surprise that people with lower incomes spend a greater proportion of their budgets on out-of-pocket costs to manage the disease. For Canadians, coverage of these costs is inconsistent across jurisdictions, leading to further inequities in access to care.

And it’s not just an economic cost, but also a personal one. Peg Abernathy, writing on the diabetes blog, calls diabetes a “medical condition that keeps us perpetually on guard”. She describes how diabetes affects her life, from its challenges to intimacy due to dropping sugar levels and dislodged insulin pumps, the roller coaster of highs and lows, the sleepless nights, and the strain on relationships. It’s a 24/7 preoccupation that permeates every aspect of the life of a person living with diabetes, and care management goes far beyond the time it takes to inject an insulin shot.

Women and T1D

The economic disadvantages of a lifetime of lower pay resulting in lower retirement and old-age pensions, means that discontinuing the Disability Tax Benefit will impact women disproportionately.

The gender wage gap touches every aspect of a women’s life influencing her economic security as well as her health and the health of her family. Traditional women’s work, and occupations that have come to be dominated by women, are paid less than men. The implications of informal and domestic caregiving often leave women with few options and dependent on part-time, low-wage employment. The impacts of wage disparity are compounded by racism toward visible minority and indigenous women leaving many women economically marginalized, their health compromised. Using a feminist analysis to uncover the implications of changes in tax policy would help expose the gendered inequities inherent in our tax legislation.

Women are often caregivers for children and elderly adults who they prioritize over themselves; this is true with time and resources. It is also true with T1D, as with any other chronic disease, that women provide significant informal and unrecognized work in the health management of family members. For women living with T1D they can be caught in a double bind situation: their needs should come first, but only after they feel they’ve satisfied those of their families. When the decision is food for the kids, no food or test strips for mom, then there are consequences to long-term care.

Canada recognizes T1D as a disability, but for the purposes of the Canadian Revenue Agency, people living with T1D fall short of the 14 hours per week of care management needed in order to quality them for the Disability Tax Benefit. Children are covered because their parent’s time is added to the child’s time, but once people living with T1D turn 18 many are now finding that they have lost access to the Disability Tax Benefit.

Creating an addition financial burden to families already cash-strapped by health care costs is not policy consistent with good government and penalizes the marginalized for their poor health status.

The accusations are that the CRA is looking to bump up revenue by being tougher on enforcing guidelines and discontinuing people who fall short of requirements. If the government really wants to find money, perhaps a national, universal pharma plan could finally come to be. Advocates (here, here) argue it would save $4 billion a year in pharma costs and eliminate the need for tax credits so people aren’t impoverished by their health care.

It’s 2017. It’s time to recognize the unpaid labour that is offered by parents, particularly mothers, daughters and spouses to help manage the care of people living with T1D and classify this disease as eligible for the Disability Tax Credit.