Germany waters down healthcare reform before Bundestag vote

German Health Minister Nina Warken (CDU) has watered down several policies in her healthcare reform before it heads to a vote in the Bundestag and Bundesrat this week. 

Warken amends healthcare commission proposals

In late 2025, the Federal Health Ministry established a Health Finance Commission tasked with “propos[ing] possible measures on both the revenue and expenditure sides of the statutory health insurance system [GKV] that would stabilise the contribution rate in the GKV as early as 2027”.

In April 2026, the commission proposed 66 austerity measures the government could implement to reduce spending on the statutory health insurance system. At the time, Warken said the government would “essentially stick to what the commission propose[d]”. 

The 66 proposed changes included: ending non-contributory dependent insurance, charging higher co-payments for medicine, reducing statutory sick pay, reducing the number of treatments that statutory health insurers provide, and shifting responsibility for funding long-term unemployed people’s health insurance contributions from the government and insurance companies to the taxpayer.

Now, the CDU/CSU-SPD coalition has drawn up a draft reform that slightly deviates from the commission's April suggestions. The Bundestag and Bundesrat will vote on the draft reform before parliament breaks for summer recess on July 10.

Which healthcare policies have been amended?

According to a FAZ report, amendments include lower additional contributions for people covered by their spouse or partner’s health insurance. 

As it stands, married couples and civil partners benefit from free spousal health insurance coverage. This means that employees covered by statutory health insurance can extend their plan to cover their non-working spouse or civil partner and their children at no extra cost.

The commission suggested that spousal health insurance should no longer be free and that the employed spouse should be charged 3,5 percent of their income before tax to insure their immediate family. Instead, the government is now planning a 2,5 percent charge.

The commission also suggested that this new 2,5 percent charge only apply to parents with children over six years old. Now, the draft states that it will apply only to parents with children over 11 years old.

If you are covered by statutory health insurance, the cost of medical prescriptions is partially covered by your insurer. However, you will typically be asked for a co-payment (Zuzahlung). This is 10 percent of the prescription cost, a minimum of 5 euros and a maximum of 10 euros.

According to the commission’s initial suggestion, co-payments will rise by 50 percent. However, an initial suggestion to automatically increase co-payments based on basic wage trends will not go ahead.

The federal government will take more, not less, responsibility for funding health insurance contributions for recipients of long-term unemployment benefits. For this, Federal Finance Minister Lars Klingbeil (SPD) has earmarked an additional 750 million euros until 2030. 

Finally, the commission also suggested cutting overall government subsidies for the statutory health insurance system to 12,75 billion euros. Cuts will go ahead, but they won’t be as big as initially planned.  From 2027, overall federal subsidies will fall from the current 14,5 billion euros to 14,15 billion euros.