What would Germany’s austerity healthcare reform mean for you?

The government-appointed Health Finance Commission (FinanzKommission Gesundheit) has announced a plan to reduce healthcare spending. Here’s what the reforms might mean for you:

Germany planning healthcare cuts

Germany’s statutory health insurance system is expected to run a 10 billion euro annual deficit from 2027 onwards unless something changes. The CDU/CSU-SPD coalition government believes the solution lies in tightening the purse strings.

In late 2025, the CDU-led Federal Health Ministry established the Health Finance Commission and tasked it 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”.

Now, the commission has published its first report and put forward 66 cost-cutting suggestions. Around 90 percent of people in Germany are covered by statutory health insurance. What would the prospective changes mean for these people? We take a closer look at the most significant suggestions:

End non-contributory dependents insurance

As was preempted by a Handelsblatt report last week, the commission has suggested scrapping “non-contributory dependents insurance”. 

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

Under the new plans, around three million spouses and partners currently covered would instead have to pay a flat rate of 225 euros per month for statutory health insurance and long-term care insurance.

This amounts to an annual household expense of 2.700 euros, which would be charged regardless of household income, meaning lower-income households would be disproportionately affected.

Higher co-payments

The commission also suggested that statutory healthcare companies charge higher co-payments (Zuzahlungen). Alongside the base statutory healthcare coverage payment (14,6 percent of an employee’s income), patients make co-payments to cover further costs, such as prescriptions, stays in hospital, home help costs or travel costs.

These are currently pretty low, for example, co-payments for subscriptions are limited to 10 percent of prescription costs (minimum 5 euros and maximum 10 euros), and hospital stay co-payments are limited to 10 euros per day.

The commission suggested increasing co-payment limits by 50 percent.

Less statutory sick pay

Currently, if you are on sick leave in Germany, you receive your full salary for the first six weeks of leave. After six weeks, your statutory health insurance provider takes over from your employer and pays you sickness benefit, which is 70 percent of your full salary for a maximum of 78 weeks over a period of three years.

The commission has suggested that people on long-term sick leave should receive 65 percent of their full salary.

Scrapping some services

The commission has suggested scrapping certain services currently covered by statutory health insurance providers, such as homoeopathic medicine prescriptions, reimbursement for medical cannabis, early screenings for skin cancer, and certain orthodontic treatments.

Higher tax on alcohol, tobacco and sweets

Alcohol and tobacco, which are relatively cheap in Germany, might become more expensive. The commission has suggested raising taxes on alcohol, tobacco and sugary drinks and estimates the change would bring in 1,9 billion euros each year in additional tax revenue.

Taxpayer would fund insurance for unemployed people

Currently, if someone is long-term unemployed in Germany, the federal government and health insurance providers share the cost of the person’s health insurance contributions.

The commission has suggested that, in future, these costs should instead be entirely financed by tax revenue, i.e. the burden would fall on working people, rather than on the government and health insurance companies.

Criticism has already been widespread

According to the commission, the 66 proposed measures would save health insurance companies around 37 billion euros annually.

But criticism of the proposals has already been widespread. Speaking on the proposal to scrap non-contributory dependents insurance, ver.di representative Jonas Wolframm said it was a “sad reflection on the situation” that the government wasn’t even willing to discuss taxing other kinds of income, such as capital gains or income from rents.

“The CDU/CSU is otherwise always quick to invoke the principle of “fairness in benefits". Why is it fair that income from work is taxed more heavily than other types of income?”, Wolframm wrote in a press release.

Criticism has also come from health insurance providers. “We have enough money in the system,” Jens Baas, chair at TK, Germany’s largest statutory health insurance provider, said in response to the proposals. Baas is concerned that statutory contributions are already too high and increasing them further would drive young people into the private health insurance system, where payments are initially lower.

Criticism from the VdK, Germany’s social welfare association, highlighted the disproportionate effects the cuts would have on women. The association said non-contributory dependents insurance “must remain untouched, particularly for families on low and middle incomes” and that abolition would “punish them for the reality in Germany that, in the past, many women were unable to work as they wished”.

What happens next?

Now that the commission has put forward its proposals, Health Minister Nina Warken (CDU) will use them to put together an austerity package. "We will essentially stick to what the commission proposes," Warken said.

Changes to the law will be drafted by the end of July and then face a vote in the Bundestag and Bundesrat. Depending on public discussion and disagreements within the CDU/CSU-SPD coalition, some changes may be made along the way.