Germany Plans Deep Health Insurance Cuts

Germany’s health minister has outlined a sweeping savings plan for the country’s statutory health insurers that could trim nearly 20 billion euros by 2027, while also reviving pressure on the government to raise taxes on tobacco and alcohol as part of a broader effort to stabilize public finances.

Nina Warken, the health minister, told lawmakers this week that more than three-quarters of the proposals from a government commission would be put into effect. According to a statement on the Bundestag’s website, the package could save about 20 billion euros in 2027 and roughly 40 billion euros by 2030. The plan comes as Germany’s sickness funds face a widening deficit and rising costs across hospitals, doctors’ offices and drug makers.

The measures under discussion would affect both insurers and patients. Among the ideas on the table are ending coverage for homeopathic treatments, dropping screening for skin cancer when there are no symptoms, reducing free family coverage for spouses and raising copayments at pharmacies from 5 to 10 euros to between 7.50 and 15 euros. Warken has said she wants to keep contribution rates as stable as possible, but the scale of the deficit has pushed her ministry toward cuts.

Health spending in Germany rose 7.8% last year to 352 billion euros, according to figures from the Health Ministry cited in the report. A forecasting panel expects spending to climb to almost 370 billion euros in 2026. That trend has intensified debate over who should pay for services that are not directly tied to insurance contributions.

One of the most contentious issues is whether the federal government should fully reimburse health insurers for the cost of covering people receiving Bürgergeld, Germany’s basic unemployment benefit. The GKV-Spitzenverband, which represents statutory insurers, says it is unfair for insured workers to shoulder those costs through premiums rather than having them financed by taxpayers. Lars Klingbeil, the finance minister, has rejected the idea that this should be treated as a federal obligation.

The Verband der Ersatzkassen, or vdek, which represents substitute health insurers, said in comments to echo24 that Warken’s package was broadly balanced and fair. But it also said it was unacceptable for the state to continue stepping back from financing so-called non-insurance-related benefits, especially the full reimbursement of health costs for Bürgergeld recipients.

The same group also urged the government to move quickly on another recommendation from the commission: higher taxes on tobacco and alcohol. The vdek said those revenues should be directed to statutory health insurance for prevention and health promotion. The Social Association of Germany has also backed higher taxes on tobacco and alcohol, arguing that they could discourage consumption and push manufacturers of sugary foods to reformulate products.

The debate matters beyond Germany’s health system because any increase in alcohol taxes could affect prices and demand in one of Europe’s largest consumer markets. That could have indirect effects on wine sales and broader beverage consumption if higher duties are passed on to shoppers.

Warken presented the package to the Bundestag’s health committee on Wednesday and answered questions from lawmakers as her ministry moved ahead with what is expected to be one of the most significant cost-cutting efforts in Germany’s public health system in years.