Health insurance companies: Health insurance contributions - stable or not?

Berlin. Calculated contribution stability: This is what Federal Health Minister Carsten Linnemann (CDU) promises after an official estimate of the strained finances of statutory health insurance companies. Nevertheless, according to the health insurance companies, at least some health insurance companies could still charge higher contributions in the coming year. The Greens in the Bundestag are already assuming a slightly higher average additional contribution than officially stated.

The group of estimators for statutory health insurance (GKV) prepared its financial forecast for this and next year on Wednesday evening. The estimated result published in Bonn results in a calculated average additional contribution rate of unchanged 2.9 percent for 2027. Immediately after the estimate was announced, Linnemann announced: “The average additional contribution rate will remain stable in the coming year.” Linnemann's ministry sets the average contribution based on the estimate.

However, it is unclear whether the individual health insurance companies will follow this or charge higher additional contributions. The average size set by regulation is only a guideline value.

Depending on their own financial situation, the individual health insurance funds themselves determine how high they will set the additional contributions for their insured persons. These are in addition to the general contribution rate of 14.6 percent of gross wages.

The Green health politician Janosch Dahmen told the “Rheinische Post” (Thursday): “The federal government is repeating a promise of stability for 2027 that has already failed due to reality in 2026.” Again, 2.9 percent is on paper, even though those insured have been paying more for a long time now. “In 2027, the average additional contribution will actually be at least 3.1 percent again.”

In the summer, the coalition decided on a cash savings package to avoid higher contributions. On Thursday morning it will be discussed again in the Bundestag: In addition to a reform of emergency care, changes to the savings plans are to be decided almost at the last minute. Some mitigations and compensatory measures are planned so that they do not become too expensive.

The austerity law provides for billions in savings. Spending curbs were imposed on practices, clinics, pharmacies and the pharmaceutical industry. In addition, there are higher co-payments for medications and restrictions on free co-insurance for spouses. The average additional contribution should definitely be kept at 2.9 percent.

However, there is a gap between this reference value and the actual contributions. According to data from the health insurance companies, the actual level of additional contributions is now on average 3.1 percent. The range among the 93 health insurance companies ranges from 2.18 to 4.39 percent.

Against this background, the statutory health insurance companies are warning the government to address remaining financial risks. At the turn of the year there will still be funds in which a minimum financial reserve has not been completely filled, said the CEO of the National Association of Statutory Health Insurance Funds, Oliver Blatt, to the German Press Agency. These “may therefore have increased financial requirements”. Blatt also cited the proposed location clause as “a significant financial risk” for the GKV.

Pharmaceutical companies in Germany should be able to be completely or partially exempt from part of a discount for patent-protected medicines, explained Blatt. “This clearly represents an industrial policy measure that could not be financed through contributions.” Here alone there is a risk of burdens of up to 1.3 billion euros - additional contribution rates would therefore have to rise foreseeably.

As things stand, the gap between income and expenses will generally not widen further next year, praised Blatt. After savings measures this year, next year will now have to be about fundamental reforms.

In their estimate, the official experts predicted expenditure of 370 billion euros in the statutory health insurance system for 2026. Next year this is expected to rise to 378 billion. Linnemann's ministry pointed out that the coffers would have to shoulder up to 15 billion euros less in expenses in 2027 because of the government's austerity package. The department head said: “We have achieved our most important goal.”

SPD health expert Christos Pantazis called the estimate in the Funke media group “good news for the around 75 million people with statutory health insurance, for employees, employers and our business location.” At the same time, Linnemann announced: “We have to solve the structural problems of statutory health insurance and put its financing on a long-term, solid basis.”