Cabinet reaches agreement: Government lets childless people pay for care reform

afp/dpa | In nursing care insurance, the premium surcharge for childless members is set to increase from January 1, 2027. It is to be increased by 0.3 points to 0.9 percent, as the Federal Ministry of Health announced after the cabinet decided on the nursing reform.

The aim of the bill is to stabilize the financing of long-term care insurance as a first step, said Minister Carsten Linnemann (CDU) in Berlin. Measures on the expenditure and income side contribute to this. After an increase last year, the contribution rate is 3.6 percent, and for those without children it is 4.2 percent of the income subject to contributions.

Linnemann said: “The system is under massive financial pressure.” The number of people requiring care has tripled: today there are six million, 20 years ago there were two million.

The reform initiated by the cabinet also contains many structural components. “That’s why I don’t want to just talk about an austerity law,” said Linnemann. In the future, as part of the nursing assessment, it should be checked more consistently whether rehabilitation can noticeably reduce the need for care.

It is also planned to increase the contribution assessment limit for care by 300 euros per month, as with health insurance. As of January 1, 2028, a premium surcharge for co-insurance of spouses or life partners of 0.52 percent is to be levied, as is the case with health insurance companies. Exceptions should apply, for example, to parents of children with disabilities or caring relatives.

In contrast to what was originally planned, nursing care insurance continues to fully cover the pension insurance contributions for caring relatives. From 2029 there will be an annual increase in nursing care insurance contributions based on inflation.

“We do not compromise on the pensions of caring relatives, because they are the silent heroes of our society,” said Linnemann. Among other things, on-site care support makes everyday life easier for those in need of care and their families.

Insured people aged 60 and over should be entitled to an early detection examination “Check-up 60+”. As announced, a structural commission will develop fundamental reforms from October, Linnemann confirmed.

After negotiations until the very end, the Federal Cabinet had previously approved the draft. The Union and SPD had discussed until shortly before the cabinet meeting. The SPD had rejected “a pure austerity package” and threatened a blockade.

After the cabinet decision on nursing care reform, the Left Party accused the SPD of giving in to its coalition partner, the CDU. “Today the cabinet decided on a care reform that largely remains exactly as Health Minister Linnemann wanted it,” said Left party leader Sören Pellmann to the AFP news agency in Berlin on Wednesday.

“The SPD’s central demand for private nursing care insurance to be involved is off the table and has been moved to a commission that is supposed to develop proposals by January,” criticized Pellmann. “But the cuts already apply now.”

The SPD had demanded that the private nursing care insurance, which is financially better off, support the ailing statutory nursing care insurance. According to Health Minister Carsten Linnemann (CDU), the coalition's internal compromise is that a commission of experts that has yet to be set up will examine whether "compensation mechanisms between the nursing care funds" are constitutionally possible and then make suggestions.

Pellmann criticized the fact that the surcharges on home costs should now be extended over time, “which would save 2.6 billion euros on the backs of hundreds of thousands of people in need of care.” In addition, access to care levels is made more difficult, and services are no longer available for care level 1.

The left-wing politician reiterated his party's demand for full nursing care insurance. This should be counter-financed by a higher contribution assessment limit, contributions on capital income and the integration of private insurance. “That would bring in over 20 billion euros a year and completely eliminate equity contributions,” Pellmann told AFP.

Patient advocates also criticized the reform compromise that had now been decided. It is “questionable whether the increase in the contribution assessment limit and the surcharges for childless people can compensate for the deficit in nursing care insurance in the next twelve months,” said Eugen Brysch from the Patient Protection Foundation of the “Rheinische Post”. "The coalition was unable to agree on the central questions for the future. If you don't know what to do next, form a commission," he emphasized.