Care reform in the Bundestag: The Care Savings Act is to be “improved”.

After storms of protest and petitions from relatives' associations and social associations, Federal Health Minister Carsten Linnemann (CDU) now wants to change parts of the draft law on the so-called Care Reorganization Act (PNOG). “We want to improve the law,” he said on Thursday during the first debate about the plans in the Bundestag.

Talks are already underway with the coalition factions to make improvements, explained Linnemann. Among other things, at the turn of the year, if the law should come into force according to previous planning, “there should not be any hard breaks”. Many people in need of care and their relatives are concerned with the concrete change in services such as preventive care. It is “essential that we do not overwhelm those affected,” said Linnemann.

Linnemann also referred to the deficit in long-term care insurance, which without the reforms would amount to almost 8 billion euros next year.

The new draft law provides, among other things, to increase the requirements for classification into care levels 1 to 3. The contribution-free co-insurance of spouses is to be restricted and the premium surcharge for those without children is to increase. In home care, services should be structured differently and brought together in new budgets.

The previous budget for so-called preventive care, which can be billed by care households for substitute care, is to be abolished according to the current draft law. Caring relatives can use the money to pay helpers on an hourly or daily basis to step in when the carer is unable to work, needs time for other tasks or needs a break. This budget is currently up to 3,540 euros per year.

If preventive care ceases, replacement care would then have to be financed from the new increased care allowance and a new so-called “social space budget”. However, these two new budgets could not compensate for the loss of preventive care.

In addition, according to the draft law, only helpers who are certified as everyday helpers “according to state law or by the nursing care insurance funds” should be financed from the “social space budget”. Trusted helpers in preventive care, such as those used by families with severely disabled children, would be eliminated, as would professional nursing staff.

Simone Borchardt, health policy spokeswoman for the Union, explained that preventative care would be “taken another look and readjusted”. She particularly mentioned families with severely disabled children who need alternative care.

“We will also make improvements when it comes to everyday assistance and the social space budget,” said Borchardt, also referring to the professional services of welfare associations. “We have good structures in the regions; those who are there should be allowed to settle the social space budget,” said Borchardt.

MPs from the Union and SPD particularly criticized the “breaking edges” according to the draft law. The tightening measures would come into force on January 1, 2027. This also includes the deletion of the so-called relief amount of 131 euros in the lowest care level 1, which household helpers can use to bill those in need of care. There should be “no hard breaks” at the beginning of the year, said Linnemann.

According to original suggestions from a working group at the Ministry of Health last year, some deteriorations in services should only apply to new cases that receive a level of care from 2027, and otherwise “grandfathering” should apply.

The SPD MP Claudia Moll called for transition periods for the new law. The facilities must at least be given sufficient time to “adjust to new conditions”.

The SPD parliamentary group also wants the private nursing care funds (PPK) to be used to balance the risk structure with the statutory, so-called social nursing care insurance (SPV). This proposal will be examined in the upcoming Nursing Commission to determine its constitutional conformity.

The adoption of the Care Reorganization Act is scheduled for December. Most of the provisions are due to come into force on January 1st.