The statutory care insurance system in Germany is facing a precarious financial situation, with leading health insurance representatives warning that several care funds could become insolvent next year, requiring emergency financial assistance to avert collapse. Despite a federal loan package of 4.2 billion euros intended to cover the projected deficit by 2026, the head of the German Association of Statutory Health Insurance Funds (GKV-Spitzenverband), Oliver Blatt, cautioned that the figures are “purely theoretical.
“The financing is so tightly balanced that we anticipate individual care funds will require liquidity support next year” Blatt stated to the Redaktionsnetzwerk Deutschland network. He emphasized that while a formal procedure exists for such interventions, it vividly highlights the urgent need for systemic reform.
The warning follows an unprecedented instance in February 2025 when one care fund was forced to request emergency funds from the care insurance equalization fund to prevent insolvency. The situation is predicted to worsen significantly in 2027 when the current loans expire, creating a projected funding gap equivalent to roughly 0.3 contribution points. Blatt explicitly stated that without reform, the care insurance system is fundamentally unsustainable.
Blatt’s critique extends to the recently concluded efforts of the federal-state working group tasked with pursuing care reform. Their findings, released in early December, were deemed insufficient and lacking tangible solutions. “I get the impression the seriousness of the situation isn’t clear to all those involved” he remarked, questioning the commitment to proactive measures.
He strongly advocated for stricter criteria for determining eligibility for care and classifying individuals into one of the five care levels. Blatt pointedly criticized past political decisions, specifically highlighting the 2017 reform that expanded access to care for individuals with dementia. He argued that policymakers at the time disregarded scientific recommendations, leading to a markedly lenient system. Since then, the number of individuals requiring care has nearly doubled, rising from three to almost six million. Blatt insists this surge is not solely attributable to demographic shifts, but is largely a consequence of the broadened eligibility criteria introduced in 2017. “We must address this development. We cannot allow this to continue” he stressed, underscoring the political urgency of the situation and the potential for a systemic crisis if reforms are not implemented swiftly and decisively. The issue underscores a deeply ingrained political difficulty: balancing compassionate care provision with fiscal responsibility within a rapidly aging society.
