The SPD is threatening to block the nursing care reform law, with which the federal government wanted to close the rapidly growing financial gaps in nursing care insurance. After the recent state elections, she is instead putting new demands for higher benefits for those in need of care on the coalition's agenda. However, Federal Health Minister Carsten Linnemann (CDU) defends the course taken by the Union and SPD before the summer break. This would close the financial gap of almost eight billion euros expected for 2027 through a mix of benefit restrictions and contribution increases.
“Our goal must be not to place an even greater burden on contributors,” Linnemann told the FAZ on Sunday. He is hoping that the draft of a care reorganization law, which has been available since June, will be passed in the federal cabinet this week without significantly changing the template drawn up by his predecessor Nina Warken (CDU). The additional burdens on contributors envisaged would close the financial gap by around half. The other part would be provided through cuts. Grants for gardening for those in need of outpatient care would be eliminated, and surcharges for nursing home residents would be extended over a longer period of time.
However, until Sunday the SPD did not give the impression that it would be prepared to discuss its counter-demands within the framework of the commission. If you block the current draft, the last resort would be to increase the general care contribution by around 0.5 percent of gross wages. SPD General Secretary Tim Klüssendorf opened the conflict on Friday evening. “One thing must be clear now: we will not accept any reduction in benefits in care,” he said. SPD parliamentary group leader Matthias Miersch took a similar position. “We need a care reform that sees care as a task for the whole of society,” he told “Bild am Sonntag”. Those with private insurance would also have to pay a “fair contribution”. His group does not want to agree to the current draft.
The private health and nursing care insurance (PKV) rejected the requested change of course as “irresponsible”. “The SPD is blocking an urgently needed care reform with ideological demands - and at the expense of employees and employers, who are already suffering from ever higher taxes,” explained PKV association director Florian Reuther.
In addition, the SPD, through the government it leads in Saarland, has introduced an initiative for a so-called cost cap for those in need of care. This would increase nursing care insurance payments to nursing home residents. The amount they would have to pay would be capped at 1,500 euros per month, regardless of the actual costs.
The paper that was written shows what this means financially, using an example of a person who is cared for in a home for five years: In total, over this time, they would receive almost 21,000 euros more from the nursing care fund than before. In a first reform stage with a limited cost cap, it would be 4,500 euros more. The additional costs for contributors and taxpayers are initially estimated at three billion euros annually. In the future they would grow with the increase in care costs.
The SPD has not included any concrete financing proposals. However, with the demand for financial compensation at the expense of private long-term care insurance, it opens up a second line of conflict in the coalition: It wants to force the currently around nine million privately insured people to pay a “soli” to the social insurance funds and their 75 million insured people in addition to making provisions for their own long-term care risk.
The SPD-led Federal Ministry of Labor recently introduced two variants into the dispute. In addition to a general “risk equalization” between the systems, it now apparently favors this variant: privately insured people who have to switch to the statutory system should “bring with them” the retirement provisions they have saved in their private contract. However, it would not benefit them personally, but would be distributed to the community.
Reports by the former President of the Constitutional Court Hans-Jürgen Papier and the Heidelberg financial and tax lawyer Hanno Kube have formulated serious constitutional objections to this. It could hardly alleviate the financial difficulties of the statutory nursing care funds due to the different size ratios. Even a transfer of 500 million euros per year would account for almost ten percent of the income for private insurance, while for statutory insurance it would not even be 0.7 percent.
Without quick savings decisions, their acute financial gap would grow to almost 17 billion euros by 2029, the current draft shows. By then, the contribution rate would have to increase by almost one percentage point. There would be additional costs due to the new SPD demands. At the same time, however, the pension contribution rate will also increase by up to 2.4 points by 2029. This would increase the total contribution burden for employees and employers in the election year of 2029 from around 43 percent of gross wages today to up to 47 percent.
The present care draft to address the acute financial gaps provides for selective additional burdens instead of general contribution increases. The premium surcharge to be paid by those without children is to rise to 0.7 percentage points. In addition, an extraordinary increase in the contribution assessment limit by 14,400 euros to 84,150 euros in annual salary is planned. Anyone with a salary of this magnitude would have to pay up to 689 euros more to the nursing care fund in 2027.
