Just before Health Minister Nina Warken introduces her health insurance finance reform law for final votes in the Bundestag and Bundesrat next week, the CDU minister has apparently implemented changes worth billions across several areas, according to reporting by the FAZ. These revisions mean that statutory health insurance members can expect fewer co-payments and less reduction in family coverage than originally planned. The Union and SPD agreed on these adjustments over the weekend, resulting in a situation where the federal government and especially the pharmaceutical industry will face greater burdens compared to the initial draft.
Within family coverage, while Kassen members must pay additional contributions for previously free partners starting in 2028-as Warken wanted-the rate is capped at 2.5 percent of their contribution-related income, rather than the initially planned 3.5 percent. Furthermore, parents caring for children up to age eleven remain exempt from this payment; the initial target threshold was six years, reports the FAZ. The burden on patients concerning drug purchases and hospital stays has also been slightly eased. Although individual participation is set to increase by 50 percent, the regular yearly rise based on the basic wage rate scheduled for 2028 has been eliminated.
Conversely, the federal government will assume a stronger financial responsibility than previously agreed upon. Cuts in state subsidies are smaller than the cabinet resolved. Moreover, Finance Minister Lars Klingbeil (SPD) commits to contributing an extra €750 million annually toward basic guarantee recipients’ healthcare until 2030; this increases from a planned €250 million in 2027 to one billion euros. Overall, in 2027 alone, an additional €1.4 billion will flow from the federal budget to statutory health insurance (GKV) than initially decided. Despite these additions, a reduction compared to current funding levels remains scheduled, dropping from 14.5 billion to 14.15 billion euros, though this is higher than the original draft’s contribution of only 12.75 billion.
Most of this additional money is mobilized by mandating that the pharmaceutical industry provide health insurers with double price discounts on medicines in the future. These manufacturer deductions-which the industry terms “forced rebates”-have traditionally been seven percent but are set to be legally required at 15.5 percent starting in 2027. The previous draft had proposed a variable, supplementary dynamic deduction based on drug expenditures and the basic wage rate, instead of a fixed percentage. In the coming years, hundreds of millions of euros will also be saved by implementing a price moratorium on vaccinations through manufacturer costs.
This compromise appears to achieve a primary goal for the coalition: despite unexpectedly high insurance payouts, contribution rates could remain stable-at least until 2028. The general contribution rate is set at 14.6 percent and the average additional contribution at 2.9 percent, totaling 17.5 percent shared between employers and employees.
It is understood that Warken had to accommodate demands from the SPD, CSU, and regional states to secure the passage of the savings package next week. However, she also managed to fend off some requests from the Social Democrats, preventing them from raising the income ceiling-the limit above which social contributions must be paid-higher than already planned in the amendment.
