CSU health policy specialist Stephan Pilsinger is calling for significant restrictions to the current system that allows spouses to be included in statutory health insurance without paying premiums. His position puts him in direct opposition to his party leader, Markus Söder. This specific regulation is currently under debate during the parliamentary process related to Health Minister Nina Warken’s Contribution Stabilization Act.
Pilsinger stated in a newsletter for Politico’s health division that he is an explicit critic of the existing rules. He argues that the fee-free spousal coverage disproportionately benefits “privileged high-income households” who are financially able to keep a partner home.
According to Pilsinger, this system is unfair, noting that workers like medical assistants and factory employees are effectively subsidizing the non-working status of spouses of high-earning individuals, such as volunteer civil servants who are lawyers or CEOs. He concluded that the arrangement is “neither particularly social nor particularly fair.”
However, CSU leader Markus Söder does not agree with Pilsinger’s criticisms, maintaining that the abolition of this coverage is “out of the question” for the CSU. Söder previously argued in March that placing additional financial burdens on families during these challenging economic times would be “completely absurd.”
The resistance is not limited to the CSU. Several district members from the SPD in Hesse and North Rhine-Westphalia have demanded in April that family coverage must remain in place. Pilsinger disagreed strongly with the Social Democrats’ position, suggesting that the issue exemplified how the SPD had lost touch with its former voters and focused primarily on an “urban academic milieu.”
The current legislative draft does not propose eliminating the fee-free coverage entirely, but intends to limit it. Under the proposed changes, spouses who wish to be covered would have to pay a contribution surcharge. Pilsinger described a surcharge of 2.5% on gross income, as currently discussed, as “reasonable.” He stressed that categories such as children, partners caring for young children, those caring for disabled children, or anyone providing care for relatives should remain covered completely free of charge, a measure he deems “socially just.”
