Federal Health Minister Nina Warken (CDU) defended her proposed reform of Germany's statutory health insurance system (GKV) against sharp parliamentary criticism on Friday during the first plenary debate on her draft legislation in the Bundestag. "Our law asks something of everyone, but nothing unreasonable of anyone," Warken said. Growing deficits in the public health insurance system had made reform unavoidable, she argued. "We are also sending a signal with this: as a country, as a federal government, we are capable of reform."
Warken told parliament that without the reform, the projected deficit for 2027 would stand at "just under 19 billion" euros, nearly four billion euros higher than had been feared until recently. "Looking at the figures makes the need for action very clear," she said. "In the future, we must bring income and expenditure in the statutory health insurance system back into balance."
The draft legislation provides for a series of cuts and additional costs for insured persons, intended to take effect as early as next year. Among the measures planned are restrictions on the currently free co-insurance of spouses, higher co-payments for medications, and cost-containment measures affecting the remuneration of doctors' practices, hospitals, and pharmaceutical companies.
The plans met fierce resistance from across the opposition benches. Politicians from the Greens, the Left Party and the AfD united in condemning the legislation as antisocial and ineffective, and vowed to fight it. "We are declaring war on this social policy," said Janosch Dahmen, the Greens' health policy spokesperson, in the Bundestag on Friday.
Dahmen questioned whether the government's central aim, preventing further contribution rate increases, would actually be achieved. "You are imposing existential cuts on patients, staff, employees and employers, and you are not even delivering what you use to justify these partly devastating cuts," he told the government directly.
The bill was built on flawed cost assumptions, he argued, warning that "despite devastating clearcuts in healthcare provision, contribution increases for 2027 will not be prevented by this inadequate, unbalanced and evidently poorly drafted law."
AfD health policy spokesperson Martin Sichert accused the federal government of putting insured persons at risk. "Your path costs human lives, as the quality of healthcare services keeps deteriorating," he said.
Sichert also linked the reform to a collapse in support for the CDU-led coalition: "Before the debate on this law, the Union polled ahead of the AfD at every institute. Since then it has dropped unprecedentedly, eight percentage points behind the AfD." He went further, threatening: "We will ensure, through massive resistance from the public, that this government fails on health policy."
Left Party health expert Stella Merendino described the legislation as a "chainsaw reform" and accused the government of cutting in entirely the wrong places. "You are cutting where people are cared for, treated and saved," she said, also predicting the government's failure on the issue. "The protests of recent days are only the beginning. Your time is truly up."
Merendino cautioned that the reform risked deepening the already severe staffing shortage in the healthcare sector. "You can pass laws, you can cut budgets, you can cap pay rises, but you cannot force a nurse, a paramedic or a doctor to remain in the profession under these conditions," she said.
Warken acknowledged that the reform was unsettling for many people, but said this must not become a justification for paralysis. "People want change too, but of course, when it becomes concrete, they also get worried," she said. "Perhaps it was precisely because of this broad and widespread criticism that changes were avoided in the past and nothing was done. But the time to act is now."
With the legislation, Warken said she wanted to "prevent contribution rates from rising further and further." "We want to relieve the burden on citizens and we want businesses to have more planning certainty, instead of being held back by ever-rising social contributions," she said. The goal, she added, was "to ensure high-quality, reliable and affordable healthcare for today and for tomorrow."
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