Local governments across Germany are demanding fundamental corrections to the proposed care reform ahead of the cabinet decision scheduled for this Wednesday, though they do support the Social Democrats’ (SPD) proposal to cap institutional care costs. This push comes amid rising financial pressures on local communities, whose spending on care assistance has surged by a third to €6 billion in the last three years, according to André Berghegger, CEO of the German Association of Cities and Municipalities (DStGB).
Berghegger told the “Neue Osnabrücker Zeitung” that a core goal of the reform must be to curb this cost increase. He noted that the currently debated spending cap could help by reducing the amount municipalities must cover when individuals cannot afford their personal share of the costs.
Burkhard Jung, President of the German Association of Cities (SPD), also called for the government to revise its draft in several key areas. While accepting that the proposed care cap could serve as a reasonable starting point, Jung stressed that the personal contribution must be significantly lowered in the long term.
Negotiations between the governing parties, the CDU and SPD, continued into Tuesday, but sources close to the coalition indicated that a resolution was not yet predictable for the afternoon. Health Minister Carsten Linnemann (CDU) had originally planned to submit his draft to the cabinet on Wednesday.
The DStGB demanded several specific changes. Berghegger urged the federal government to repay funds withdrawn from the care fund during the pandemic to ensure financial stability. Furthermore, he insisted on the implementation of a permanent, dynamic federal subsidy for health insurance, drawing parallels with existing systems like pension insurance. He asserted that care is a shared societal responsibility and must be financed accordingly, adding that the federal states (Länder) must also fulfill their duty by contributing to infrastructure financing to lower institutional costs.
Jung warned the municipalities not to support a reform pushed through in the next cabinet meeting without careful consideration. He emphasized that the reform must not shift a substantial portion of the care insurance funding problem onto local communities. While agreeing that the current spending cap is a suitable initial step, he reiterated that the self-contribution must be further reduced to minimize the risk of poverty among those requiring care. Looking ahead, the Association of Cities is advocating for a comprehensive care insurance scheme to cover all necessary care costs.
