Alternative federal budget 2026-27: Seniors’ care and long-term care

This is from a larger publication, Alternative federal budget 2026-27: Bridge to independence

Introduction

The two most recent budget statements have largely ignored seniors’ care. Even if you leave aside the human right to care, regardless of age, and the federal commitment to gender equity, this doesn’t make economic sense.

A growing number of seniors are still employed¹ and many seniors make critical contributions to the economy through volunteer work. Although they make up 13 per cent of the population, Canadians aged 65 to 74 contribute 20 per cent of total volunteer hours.² Both kinds of work help keep seniors healthy but require support. For example, significantly improved access to safe long-term care would be especially important for keeping both senior and younger women in the labour force, given that women currently do the bulk of unpaid care provision—often to the detriment of their own health. Equally important, ensuring timely access to health care and community services can help keep seniors healthy enough to participate while reducing the demand for more long-term care.³

Yet neither the 2025 fall budget nor the 2026 spring economic statement provides support for even continuing the pharmacare that has helped so many seniors with diabetes. The federal government has reduced support for health and homecare services. There is no mention of a previously promised Safe Long-Term Care Act nor any support for the workers—primarily women and often racialized—who are leaving long-term care work because of the poor conditions.

Overview

The AFB understands seniors’ care as a critical infrastructure component, recognizing the human right to quality care and to quality care work. With the COVID-19 pandemic’s devastating impact on seniors, its exposure of the weak and asymmetrical supports for seniors’ care across Canada, and the resulting demands for action, the federal government introduced a host of programs examined in previous AFBs.

The Trudeau government provided funding for the development of new long-term care standards and for their operation and design, promising a Safe Long-Term Care Act in its wake.⁴ There was additional funding to pay and hire long-term care (LTC) staff (with extra for those in remote areas), for international recruitment, for protective equipment and vaccines, and for data-tracking of the care labour force. Home and community services also received additional funding and support for restart programs. And there was funding to create and support organizations to do policy development on unpaid care. The dental plan, even though means-tested, undoubtedly helped many seniors eat and have broader health issues detected. Pharmacare covering diabetes medication, although only introduced in four provinces, also contributed to seniors’ health, as did the increases in Old Age Security for those over 75, money for housing repairs and targeted funding for Indigenous health.

But there was little enforcement of the principles underlying the funding to ensure the money was spent as promised, to ensure that standards were met, or to prevent it from going to profit instead of to care. Now, very few of these initiatives are being continued, let alone expanded, by the current federal government. In the 2025 budget, the few references to seniors are about existing, legislated programs, such as Old Age Security (OAS), or small programs, such as the old Horizons program, which has been touted as a health program that keeps people in their communities. The other references to seniors list them along with “other vulnerable groups” who can receive advice on finances, taxes and fraud prevention, or improvements in weather forecasting, or Veterans Independence Allowance (VIA), or more efficient government services and support for housing and food programs. There seems to be no intention to expand pharmacare to other drugs or to other provinces—as promised by the Trudeau government—or to make dental care universal. There is nothing to address the labour crisis in paid and unpaid seniors’ care.

That many of these areas are under provincial/territorial jurisdiction is no excuse. The federal government has long used its spending power to establish principles, standards and enforcement mechanisms that provide national programs based on shared values while allowing for jurisdictional differences.

Actions

The AFB will transform housing and living options for seniors. This will be done through funding envelopes for publicly owned, publicly delivered and affordable housing options that integrate care services and provide smooth transitions as care needs change.

The AFB will transform how seniors’ care is delivered by funding the development of standards for home care, social housing for seniors, assisted living and retirement homes. The AFB recognizes that standards do not mean standardization, and that accountabilities should therefore indicate how populations, locations, cultures, languages and other conditions are taken into account.

The AFB will make funding conditional on the demonstrated application of standards that apply to the entire range of services and to those who provide care. This means funding for long-term care, home care and seniors’ assisted living will be conditional on addressing working conditions for seniors’ care. This may include setting provincial/territorial wage floors for common classifications, implementing minimum sick leave entitlements, reducing inequities among care workers employed in different sectors of seniors’ care, as well as other provisions across all health care settings.

The AFB will invest directly in expanding non-profit home care and facility-based long-term care to ensure that care can be provided to everyone who needs it, where it is needed most. It will also invest in funding options for seniors’ housing that can provide intermediate care, such as assisted living, retirement homes and co-operatives with the goal of expanding capacity by 100,000 beds over five years.

The AFB will, in keeping with the federal housing strategy, provide funding to provinces and municipalities to build, own and operate high-quality, public non-profit seniors’ care facilities.

The AFB will make any funding for long-term care, home care, and seniors’ assisted living conditional on phasing out the use of for-profit staffing agencies, working with provinces and territories to establish a central non-profit agency to supply staff to address temporary shortages, ensuring wages and conditions are harmonized with local employers.

The AFB will make funding for long-term care, home care, and seniors’ assisted living conditional on establishing daily hours of direct care standards that are enforceable and that would ensure minimum requirements for full-time work in every workplace.

As the recommended research-informed practice for care evolves, the AFB will fund more than 115 million additional hours of direct care annually, to a minimum of 4.2 direct care hours per day per facility. This will be met through a commitment of $18.1 billion over three years. It is estimated that direct care hours provided in seniors’ facilities averaged just three hours per day across the country, with the costs of meeting a minimum of four hours per day of direct care assessed at $4.3 billion annually.

The AFB will continue with pharmacare expansion. It will renew the Trudeau era Aging with Dignity program and mental health parts of the “working together” bilateral agreements which are to expire soon and are essential for seniors (see the Health care chapter).