Nina Warken, Germany’s health minister from the conservative CDU party, has proposed a reform — though viewed differently by critics — that aims to change key parts of the country’s health care system, focusing on reducing costs and stopping further increases in insurance contributions.
According to the government, without intervention, the system could face a budget shortfall exceeding €15 billion by 2027.
There is a significant need for action. Without decisive countermeasures, the imbalance in statutory health insurance (GKV) finances will continue to worsen. Based on the report of the Financial Commission for Health, we now have effective and balanced measures. It is important that everyone contributes. Otherwise, we will not be able to cover the deficit. Our goal is to close the expected financial gap by 2030 and keep contributions stable. With the proposed package, this is possible.
Federal Minister of Health Nina Warken
At the core of the proposal are several changes that would directly affect patients and providers. Prescription fees are set to rise, with patients expected to pay between €7.50 and €15, compared to the current €5 to €10 range. Additionally, costly procedures such as hip or knee surgeries would require mandatory second opinions from independent doctors who do not financially benefit from performing them.
Another significant shift concerns family insurance coverage. Starting in 2028, spouses without their own income — who are currently insured free of charge — would be required to contribute a flat rate of 3.5% of their partner’s income. Reduced rates and exemptions would apply to lower-income households, caregivers, pensioners, and parents of young or disabled children.
The reforms also propose eliminating insurance coverage for homeopathy, increasing mandatory discounts from pharmaceutical companies, and introducing stricter limits on administrative, advertising, and executive costs within public insurance funds.
Financial incentives for family doctors — such as extra payments for walk-in consultations or referred patients — would also be scrapped.
The draft legislation is expected to be approved by the cabinet at the end of April, followed by votes in both the Bundestag and the Bundesrat before the summer recess.
The reforms come amid growing financial strain on the system. Contributions to public health insurance have already risen by an average of 3% in 2026, following a 2.5% increase the previous year, while spending continues to grow at a faster pace.
Background: current system under pressure
Germany’s health care system operates under a dual structure, with mandatory insurance for all residents. Around 90% of the population is covered by public insurance, funded through income-based contributions shared between employers and employees, while the remaining 10% opt for private coverage.
The system is among the most expensive worldwide, with public insurers alone spending roughly €1 billion per day.
Financial pressures are expected to intensify, with the gap between income and expenditure projected to widen sharply — from €15.3 billion in 2027 to €40.4 billion by 2030.
21.04.2026.
SOURCE
Federal Ministry of Health Germany https://www.bundesgesundheitsministerium.de/ministerium/meldungen/gkv-finanz-reform-14-04-2026 Translated by AI
