German care reform lands as a €20bn austerity package, drawing fire from unions, insurers and the SPD
Health minister Nina Warken's draft law to stabilise the insolvent long-term care insurance system would shift costs onto families, cut pension credits for carers and tighten eligibility, triggering a wave of protest from the nursing council, unions, insurers and even her own coalition partner.
The deficit that forced the package
Without reform, Germany's statutory long-term care insurance faces a deficit of roughly 7.5 billion euros in 2027, rising to 15 billion euros by 2028, according to figures from the health ministry cited by multiple outlets. Health minister Nina Warken (CDU) presented a draft law on Thursday that aims to close the gap through a mix of spending cuts and additional revenue, avoiding a general contribution-rate hike. The package is projected to deliver a combined financial effect of 11.25 billion euros in 2027, climbing to 20.34 billion euros annually by 2030.
- 2027
- 7.5 billion EUR
- 2028
- 15 billion EUR
What the draft changes
The reform tightens access to care grades by adjusting the assessment system, a move the ministry says is meant to slow the rise in the number of people classified as needing care. Savings from this measure alone are put at 2.5 billion euros in 2028 and 4.2 billion euros by 2030. For nursing-home residents, the staggered supplements that reduce their co-payments will each be delayed by six months: higher subsidies that currently kick in after 12, 24 and 36 months would instead apply after 18, 30 and 42 months. The shift is expected to save 2.6 billion euros in 2027 and a further 2.7 billion in 2028.
Pension contributions paid by the care insurance for family carers are to be capped at 70 percent of their current level, saving the funds 1.8 billion euros in 2027 and 2.1 billion by 2030. The childless surcharge rises by 0.1 percentage points to a total of 0.7 contribution-satz points, and the contribution assessment ceiling is lifted to the level of statutory health insurance, generating an extra 1.6 billion euros in 2027. The planned annual increase in care benefits will also be dampened: a lower dynamisation rate saves 4.05 billion euros in 2028, with savings staying above three billion in subsequent years.
- 2027
- 11.25 billion EUR
- 2030
- 20.34 billion EUR
The nursing council's verdict
The German Nursing Council's president Christine Vogler told the Redaktionsnetzwerk Deutschland that the reform is a short-term consolidation exercise rather than a plan to secure care provision.
She argued that the care need does not disappear but is merely shifted out of the insurance system and into families, municipalities and other parts of the health system. The council is especially critical of the pension-contribution cut for family carers, saying it worsens the position of the very people who already carry the largest share of care in Germany.Benefits are being restricted, subsidies take effect later, access is being re-steered and entitlements reduced.
Broader opposition from unions and insurers
VdK president Verena Bentele called the pension-contribution cut a blow to the face of family carers, warning it would deepen old-age poverty among women. DGB chair Yasmin Fahimi demanded the government withdraw the draft, describing the delayed subsidy steps for nursing-home residents as a cynical bet on residents dying before they qualify for higher support.
The head of the statutory health insurance association, Oliver Blatt, welcomed the fact that a proposal exists at all but said too many burdens fall one-sidedly on those needing care and on contributors while the federal and state governments keep their own financing lean.Saving costs this way is perfidious and inhumane.
Coalition and party tensions
Green health expert Janosch Dahmen told dpa that the largest single savings item consists of restricting access to care services, and that costs do not vanish but reappear elsewhere. The SPD, the CDU's coalition partner, also pushed back. The party said the draft remains indebted for a central answer to the financial crisis of the care insurance system. CDU parliamentary group leader Jens Spahn defended Warken in an ARD interview, stating that the care insurance — like the health insurance — is simply bankrupt after years without real economic growth.
Warken herself told ARD's Tagesthemen that a broad approach was necessary and that a lot of change naturally invites a lot of criticism.The money that we did not collect through more growth is now missing.
- Draft law presented by health minister Nina Warken
- Warken defends the package on ARD Tagesthemen
- Nursing council president Vogler calls the reform a short-term savings programme
- SPD, Greens, unions and insurers issue coordinated criticism
