Federal Health Minister Nina Warken (CDU) is scheduled to present her proposals for reforming the social nursing care insurance system by mid-May, but coalition partners have voiced sharp criticism regarding the yet-to-be-released plans.
Christos Pantazis, the SPD’s parliamentary spokesperson for health issues, stated that any announced care reform must address more than merely efficiency or economic reserves. These plans must also explain how the system’s funding base will be stabilized in the long term. Pantazis reasserted the SPD’s demand for a “citizen insurance” model for care, arguing that the varying risk structures between public and private care insurance cannot be permanently overlooked. According to Pantazis, the public insurance covers the majority of older, multimorbid, and costly insured individuals, while the private pay obligations possess a structurally cheaper and income-stronger risk pool. He insisted that this difference must be discussed openly. While clarifying that the goal is not to pit public and private insurance users against each other, he stated that the focus must be on the stability of the care system and the question of fair burden sharing when facing a common life risk. “After all, a simple principle applies: equal care services, common risk, fair burden sharing” the health politician stated.
Minister Warken’s draft law is set to potentially impose significant financial burdens on care-dependent individuals living in facilities and generally restrict access to care insurance services. Among her announced measures, she intends to rely on scientific expert recommendations for classifying care levels 1 through 3, a set of guidelines developed prior to their initial implementation. She also brought attention to an expected deficit in the nursing care insurance for 2027 and 2028, estimating the combined shortfall at €22.5 billion, marking an increase from initial forecasts.
Prior to the publication of the legislative draft and on the occasion of Care Day, the Association of German Elderly and Disabled Aid (VDAB) also highlighted the urgent need for reforms. Thomas Knieling, VDAB’s federal director, told the press that given rising care needs and restricted resources, rapid and reliable political decisions are essential. He concluded that the upcoming reform must lead to the urgently needed structural overhaul of the sector. Knieling emphasized that the economic foundations of professional care facilities must be permanently guaranteed, stating that only with viable care providers can the care for dependent people be ensured across the board in a sustainable way.
Meanwhile, the German Professional Association for Care Occupations (DBfK) appealed directly to the federal government, warning that “care cannot become a maneuverable tool for short-term austerity policies” according to DBfK President Vera Lux. This warning applied equally to the reform of statutory health insurance and the reform of care insurance. Lux cautioned that capping the care budget, weakening relief measures, or labeling care staff costs as a cost driver jeopardizes service security and patient protection. From the DBfK’s perspective, the necessary steps include establishing mandatory staff ratios, improving working conditions, strengthening professional training, expanding the powers of highly skilled care staff, and ensuring the involvement of the care sector in all stages of reform planning. Furthermore, she stressed that “Care Day cannot remain a ritualized day of thanks; it must become a political mandate”.
