Federal Health Minister Nina Warken of the CDU has issued a stark warning to state governments, urging them not to obstruct the cost-cutting measures for the statutory health insurance (GKV) already approved by the Bundestag in the Bundesrat. In a letter to her counterparts in the state governments and reported by POLITICO, Warken cautioned that any challenge to these regulations would likely force health insurance funds to abandon planned budget relief, directly impacting the determination of supplementary contribution rates.
The potential consequences, according to her assessment, include a significant increase in the supplementary contribution rate to 3.0 percent, placing an additional burden of up to two billion euros on contributors. This threat is particularly relevant as the Bundesrat prepares to debate the Care Competence Act this Friday, a bill containing several time-critical GKV regulations slated to take effect January 1, 2026.
Warken denounced the Care Competence Committee’s recommendation for invoking the Conciliation Committee as a “highly problematic signal” emphasizing that such a blockade would imperil regulations essential for maintaining quality care, reducing bureaucratic hurdles in the care sector and ensuring stable contribution rates. The potential for damage to public trust in the government’s ability to act decisively is considerable, she warned.
The Minister recently capped the average GKV supplementary contribution for 2026 at 2.9 percent, stating that planned measures, including the temporary suspension of the “most-favored-nation clause” – curtailing the budgets of psychiatric and psychosomatic hospitals – are key to maintaining this rate. This suspension, a particular point of contention with the states, is presented as a “proportionate intervention” considered necessary given the significant rise in hospital expenditures since 2024. Critics argue that the move unfairly targets mental health institutions and the escalating cost control measures raise deep concerns about the long-term sustainability of the German healthcare system and potential rationing of care. The escalating tension highlights a fundamental divide between the federal government’s pursuit of budgetary control and the states’ responsibilities for healthcare provision.
