Bundestag to debate Linnemann's care reform, leaving a 7.6 billion euro gap

Shortfall and the first reading

The Bundestag will hold its first reading of the government's care bill on Thursday, 5 November, a draft by Health Minister Carsten Linnemann (CDU) meant to stop general contribution increases in the new year. Linnemann puts the shortfall in care insurance at 7.6 billion euros for 2027 and warns it could reach 15 billion euros in 2028 without countermeasures. Spending already stands at 74 billion euros a year. The measures are expected to bring in 6.25 billion euros in 2027, so a gap would remain. Several changes are due to take effect on 1 January 2027, and the cabinet adopted the draft at the end of September after a dispute that ran to the last minute. The coalition groups in parliament can still amend it.

2027 projected shortfall7.6

2027 measures' expected effect6.25

2028 possible shortfall15

2027 projected shortfall

7.6 billion euros

2027 measures' expected effect

6.25 billion euros

2028 possible shortfall

15 billion euros

Data from the article text

Who pays more

Childless insured people face the clearest increase. Their surcharge rises by 0.3 percentage points to 0.9 percent from 2027, which the government expects to bring in about 3.3 billion euros, taking their total contribution to 4.5 percent of gross pay against 3.6 percent for people with one child. The contribution ceiling would rise once by 300 euros a month, costing higher earners at most 17 euros more a month and bringing the state roughly half a billion euros. Spouses who are currently insured free of charge would pay a 0.52 percent surcharge from 2028, although children, parents of children under 12 and people caring for relatives keep their free cover. Employers would also pay care contributions for minijobbers from 2028.

Cuts for people in care

Care level 1 would become harder to reach, and the planned relief budget for that level would be scrapped despite continued criticism. For care levels 2 to 5 the draft would cap cost increases in cash benefits, care-service benefits and respite care, which are normally adjusted to price rises. The scheduled 2028 increase would fall away, and annual inflation-linked adjustments would only begin in 2029. Planned pension cuts for family carers have been dropped. Dirk Wiese, first parliamentary business manager of the SPD group, has criticized a hard cliff edge in the relief amount and wants transitional rules, pointing to care providers who may have to end employment contracts by 1 January.

Relatives and the human cost

A 54-year-old woman from Hamburg has spent more than four years organising care for her mother, who has Alzheimer's, and describes the paperwork and constant worry involved. Her mother now lives in a care home nearby after a period in another town about an hour's drive away. Linnemann presents the reform as a push for care at home and, in an interview with RP Online, said:

“I know home care from my own family, and that is why I know that care is different in every family.”

He also wants prevention, counselling and rehabilitation to delay the need for care.

Critics and what remains open

Katrin Staffler, the government's care commissioner, warned that more burdens on relatives would hit hard, and she told Bild that relatives work a 24-hour job and need breathing room. Anja Piel of the German Trade Union Confederation (DGB) said the bill needs real improvements rather than further savings:

“Instead of further savings, people in need of care and insured people finally need noticeable improvements.”

Piel named a cap on out-of-pocket costs as one of the most important points. Oliver Blatt, chairman of the GKV umbrella association, called for a fairer distribution of the burdens. A separate expert commission is due to propose a long-term structural reform by the end of the year.