epd/dpa/ | Facing multi-billion gap-funding in long-term care and health insurance, Federal Health Minister Nina Warken (CDU) is pressing for quick steps. The statutory health insurance fund is “financially under massive pressure,” the minister said on Friday in Berlin. There is a need for short-term measures and long-term, effecting structural reforms.
Although the statutory health insurers (GKV) posted a surplus of 2.8 billion euros in the first half of the year, this was used to fill up the very low financial reserves to the legally required minimum reserve. In recent years there had been a massive depletion of reserves.
Moreover, the expenditures of the health insurers continued to rise. In the first half of the year, the around 90 statutory health insurance funds spent 166.1 billion euros on their benefits. That is an increase of 7.95 percent compared with the same period last year, according to new figures from the GKV-Spitzenverband.
For the coming year, the deficit of the statutory health insurance amounts to four billion euros, while in long-term care a financing shortfall of two billion euros threatens, Warken explained: “Without deep reforms, the system cannot finance itself any longer.”
Loans from the Federal Government
The federal government is making a large contribution to stabilizing the health insurers, according to Warken, including loans of 2.3 billion euros for the current year and the coming year. These funds are already provided for in the budget drafts for 2025 and 2026 that the cabinet has initiated. However, the Health Ministry had signaled several times that this would not be enough to prevent premium increases at the beginning of 2026. Warken repeated this assessment on Friday: the aid would “with a high probability be insufficient” to stabilize contributions with regard to the coming year.
Additional money is not being provided by the Black-Red coalition in the 2025 budget, said Union budget expert Christian Haase after the final committee deliberations. The CDU politician also pointed to the coalition leadership’s goal of avoiding premium increases. SPD budget expert Thorsten Rudolph said proposals from Health Minister Nina Warken (CDU) regarding the 2026 budget are expected.
For long-term reforms, the minister announced the establishment of an expert commission this month. It is to present first results as early as spring 2026, which will take effect from 2027. The aim is to break through the “nearly routine” annual contribution increases at year’s end. Structural reforms should lead to greater efficiency, Warken said, such as a primary-care physician system, a reform of the emergency and rescue services, and an adjustment of the hospital reform passed under her predecessor Karl Lauterbach (SPD).
Black-Red Coalition Aims to Keep Contributions Stable
Recently, at the start of 2025, there were contribution increases: the funds raised the additional contribution to an average of 2.9 percent, on top of which the general contribution rate stands at 14.6 percent of gross wages. Black-Red repeatedly emphasizes wanting to keep contributions stable, a point reaffirmed again in the coalition committee on Wednesday evening. The contributors should not be further burdened, and the urgently hoped-for upturn in the economy should not be endangered further by contribution increases.
The funds attribute the poor financial situation mainly to the legislation of recent years, as explained by a spokesperson for the association. For example, caps on fees were abolished for more and more medical services, and price controls for medicines were relaxed.
Oliver Blatt, the chairman of the GKV-Spitzenverband, called for a moratorium on spending and structural reforms. These should be noticeable for insured people in everyday life – for example through faster doctor appointments. In the long term, Blatt also wants to prevent the gap between expenditures and revenues from widening further, and “return to stable finances.” In principle, it must be prevented that the health insurers have to spend more than they collect. The rise in costs must be brought back to “a normal level.”
