Shortly before the planned cabinet decision, Germany's grand coalition has reached an agreement on a legislative proposal to reform the statutory health insurance system. According to the new draft legislation obtained by news agency AFP on Tuesday, savings of €16.3 billion are now projected by 2030. The original draft had envisioned larger savings of nearly €20 billion.
However, the revised figure still exceeds the anticipated funding gap of €15.3 billion in 2030. In subsequent years, the expected savings are set to increase significantly according to the new legislative proposal: to €23.2 billion in 2028, €31.2 billion in 2029, and €38.3 billion in 2030.
The coalition has agreed on several major modifications to the original proposal. Sick pay will now be maintained at its full amount and will not be reduced. Instead, pharmaceutical companies will be required to make a higher contribution. Additionally, the coalition plans to raise both the contribution assessment ceiling and the mandatory insurance threshold.
Currently, the latter stands at €77,400 annually. Only employees with a gross annual income above this threshold can switch to private health insurance. The mandatory insurance threshold will now be raised by an additional €300 per month starting in 2027."
The controversial cuts to free co-insurance for family members remain part of the reform – despite criticism from the SPD and CSU.
Beginning in 2028, a levy on sugar-sweetened beverages will be introduced. According to the draft legislation, the government expects annual revenues from the sugar tax of approximately €450 million. These funds are intended to provide relief to the statutory health insurance system "in an appropriate manner."
A new provision addresses insurance costs for individuals receiving basic income support. The tax subsidy for this group will be increased on a "growing basis" starting in 2027. The plan allocates €250 million for 2027, €500 million for 2028, and "annually increasing additional expenditures of €500 million each year from 2029 to 2051," according to the draft.
At the same time, the federal government intends to reduce its contribution to the health fund by €2 billion annually from 2027 through 2030.
The health insurance funds sharply criticized the planned change. The bottom line is that less federal funding will flow into the financially pressured insurance system, emphasized Oliver Blatt, CEO of the National Association of Statutory Health Insurance Funds. 'Instead of supporting contribution payers, the federal contribution is to be cut by a total of €1.75 billion next year.
Blatt added: 'The originally balanced reform package threatens to become unbalanced, because co-payments are still to be increased and the pharmaceutical industry is to be spared.'
There had been demands from both the CDU/CSU and the SPD for increased tax subsidies for those receiving basic social security benefits. However, due to budgetary constraints, the SPD-led Federal Ministry of Finance had previously rejected such proposals. Currently, the statutory health insurance funds, and therefore the insured individuals, bear the majority of insurance costs for basic social security recipients."
Sources within the SPD stated on Tuesday that the health insurance legislative proposal "has been clearly improved through negotiations for policyholders and employees." The reform will become "more equitable and socially balanced overall" as a result.
There had been demands from both the CDU/CSU and the SPD for increased tax subsidies for those receiving basic social security benefits. However, due to budgetary constraints, the SPD-led Federal Ministry of Finance had previously rejected such proposals. Currently, the statutory health insurance funds, and therefore the insured individuals, bear the majority of insurance costs for basic social security recipients.
The federal cabinet is scheduled to approve the health insurance reform legislation on Wednesday, after which the Bundestag will take up the matter. SPD sources have already indicated that "further improvements to the reform for families and policyholders" will be discussed during the parliamentary process.
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