The expert panel warns that without intervention, the funding shortfall will force contribution rates to rise significantly. Insured individuals and employers would face average additional costs of approximately €260 in 2027, escalating to about €680 in 2030, with maximum additional burdens reaching €1,440 annually by the end of the decade.
These mounting costs stem primarily from a sharp increase in expenditures, according to the commission's calculations. The widening gap threatens to place increasing strain on the solidarity principle underlying Germany's statutory health insurance system.
Among the most significant proposals is transferring responsibility for basic security recipient insurance costs from the health insurance funds to the federal government. This single measure would relieve the statutory health insurance system of €12 billion annually. Eliminating free coverage for non-working spouses would generate savings of €3.5 billion, while increasing medication co-payments from the current €5-€10 range to €7.50-€15 could yield €1.9 billion in the first year alone.
The tax measures would contribute additional revenue: tobacco tax increases could bring in €1.2 billion, alcohol tax increases €0.6 billion, and a graduated tax on sugar-sweetened beverages €0.1 billion.
Central to the commission's recommendations is stronger alignment between expenditure development and revenue. Additional pillars include strengthening evidence-based healthcare delivery and advancing prevention strategies. On the revenue side, the commission recommends measures to promote social insurance-covered employment and appropriate tax financing for insurance services that extend beyond traditional coverage.
"The proposals open up a broad scope of action for policymakers to continue shaping the system," said commission chair Wolfgang Greiner. "In particular, they help ensure that health insurance funds do not spend more than they take in, thereby preventing rising contributions and additional burdens for insured individuals and employers."
The commission argues that implementing the recommendations could lead to significant savings as early as next year, helping stabilize the finances of statutory health insurance in the short term beginning in 2027.
"I am grateful that the commission has presented us with a well-stocked toolbox from which we will select the best tools," said Minister Warken at the presentation. She announced plans to introduce "a comprehensive package very soon and also after coordination within the federal government." The minister promised that the overall reform package would be "socially compatible and economically viable."
Federal Health Minister Warken established the ten-member Health Finance Commission in September. The commission includes scholars from economics, medicine, social law, ethics, and prevention. Their proposals will serve as the foundation for the planned financial reform of the healthcare system by the grand coalition government.
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