According to estimates provided by IT service provider Bitmarck, and reported by the “Rheinische Post” spending within the statutory health insurance system (GKV) is projected to increase significantly faster than revenues this year. Looking ahead to 2026, expenses are expected to rise by seven percent, marking a slowdown from the 7.8 percent growth recorded in the previous year. This growth rate, however, considerably outpaces the projected increase in revenue. While revenues grew by an estimated 3.7 percent in 2025, the growth is expected to reach six percent this year. Consequently, the shortfall in the health fund is predicted to rise to 59 billion euros, up from 52 billion euros in 2025. The report characterizes this situation as a “high structural deficit”.
Beyond the national figures, concerns persist regarding the financial stability of individual funds. In 2025, nearly 60 percent of the funds operated with reserves below the required minimum. This minimum reserve is set at equivalent to 20 percent of a month’s expenditure and is intended to stabilize supplementary contributions and absorb fluctuations in spending. Although increased contributions are expected to reduce the proportion of funds below this threshold by the end of the year, Bitmarck forecasts that by the end of 2026, one in three health funds will still lack adequate reserves.
In response to these escalating deficits, the Federal Cabinet passed a draft reform bill for the GKV in late April. The proposed legislation aims to stabilize member contributions in the coming year while simultaneously resolving the existing deficits within the various health insurance funds.
