Germany’s statutory health insurers are preparing to take the federal government to court in an effort to secure relief from the high costs of covering citizens receiving citizen's benefit (Bürgergeld). “For the health insurance of people receiving citizen's benefit , the federal government fails to provide statutory health insurers with around ten billion euros every year,” said Susanne Wagenmann, chairwoman of the administrative board of the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband), in Berlin on Thursday. This underfunding, she stressed, is unlawful.
At present, these costs are borne by the statutory health insurers, and thus by the 75 million insured members and their employers. At its meeting on Thursday in Berlin, the GKV board therefore resolved to file suit against the Federal Republic of Germany to compel it to assume these costs, according to a press release.
“We are experiencing that, when it comes to contributions for citizen's benefit recipients, the state relieves itself at the expense of GKV contributors,” Wagenmann said. The result, she argued, is higher labor costs for companies and reduced take-home pay for employees. “This approach by the federal government harms Germany as a business location, because work becomes ever more expensive.”
Co-chair of the board Uwe Klemens declared: “Enough is enough! We now feel compelled to pursue legal action and to file suit.” The association wants to ensure, he said, “that our insured members and their employers are no longer burdened with a financing task that is the responsibility of the state.” Until now, the federal government has left the insurers to cover “about two-thirds of the costs” of insuring citizen's benefit recipients.
According to GKV, in 2022 the federal government paid a flat-rate contribution of €108.48 per month for each citizen's benefit beneficiary. In order to cover the insurers’ expenses, however, the federal government should have paid €311.45 per month. Such discrepancies, the association argued, have “burdened the solidarity community of the GKV for many years to the tune of billions.”
In its lawsuit, the association contends that the financing of health coverage for citizen's benefit recipients “falls under the sole responsibility of the federal government.” The current underfunding, it claims, represents “an unlawful encroachment on the social insurance providers’ right to organizational and financial independence.”
The GKV also cites case law from the Federal Constitutional Court, which has ruled that social security contributions may not be used to finance general societal tasks. The defendant in the case is the Federal Republic of Germany, represented by the Federal Office for Social Security. Jurisdiction for the initial proceedings lies with the State Social Court of North Rhine-Westphalia.
In 2024, the total expenditures of statutory health insurers exceeded €327 billion, with a sharp upward trend. The federal government is therefore considering reforms to curb rising costs. Jens Baas, head of Techniker Krankenkasse (TK), described the lawsuit as “a question of justice.” Under the current system, he argued, GKV contributors are disadvantaged because private insurance policyholders pay nothing. The care of citizen's benefit recipients, he emphasized, is “a task for society as a whole.”
The trade union Verdi also welcomed the lawsuit. Without relief for statutory insurers, their members risk “reduced benefits, higher contributions, and, under the plans of some politicians, even health protection determined by individual income,” warned Verdi chairman Frank Werneke.
Left Party health expert Ates Gürpinar likewise cautioned against looming cutbacks in statutory health insurance. “That is why it is good and right that the health insurers are now demanding realistic contributions for the coverage of citizen's benefit recipients,” he said in Berlin. Gürpinar also called for a unified system of health and long-term care insurance “into which everyone pays.”
Federal Health Minister Nina Warken (CDU) is expected on Friday in Berlin to present the government’s newly established commission on stabilizing statutory health insurance.
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