Now that the government has agreed on a “nursing care reorganization law”, many detailed questions remain unanswered. A commission of experts will discuss major structural reforms and submit proposals by the end of January 2027.
According to Health Minister Carsten Linnemann (CDU), the commission will not deal with the cap on personal contributions for care costs in the home demanded by the SPD. “No, he’s not going into the commission,” said Linnemann on ZDF. "A lid is extremely dangerous."
Linnemann argued that the SPD proposal only saves “perhaps 300 euros” for those affected - with a personal contribution of more than 3,000 euros. He also expressed concern that a cap could lead to “costs escalating further” because providers increase prices.
Instead, the minister announced: "We will tackle the issue by introducing socially acceptable performance subsidies."
SPD sticks to “care cover”.
The SPD, on the other hand, explicitly mentioned the “care cap” it proposed as part of the program for the commission. “The nursing commission now has the task of presenting concrete results for structural reform within the next few weeks,” said deputy group leader Dagmar Schmidt. This includes a “care cap that effectively protects those in need of care and their families from ever-increasing personal contributions.
Scientist calls for “political agreement”
The Bremen health economist Heinz Rothgang is also calling for a cap on care-related personal contributions in the home. The last discussed value of 1,500 euros is only around 300 euros less than today's burden. But future development is crucial, because the company's own contributions have been increasing for years, he said in the tagesthemen.
Overall, Rothgang doesn't expect any major success from the commission. Some of the proposals have been on the table for many years and have been recalculated several times. “What is necessary is a political agreement. You can put forward sensible proposals, but of course a commission cannot force political agreement."
CDU Economic Council against raising the assessment limit
There is also criticism of the reform beyond the aspect of a “care cap”. The CDU Economic Council sees the increase in the contribution assessment limit for long-term care insurance as “a wrong signal”. It endangers the “economic dynamism of our country,” warned the Secretary General of the CDU Economic Council, Wolfgang Steiger, in the Augsburger Allgemeine.
Those who rely more and more on even higher contributions for service providers "put a strain on work and employment and ultimately weaken the foundation on which the financing of our welfare state is based." However, the Economic Council sees positively that prevention and rehabilitation should play a stronger role in the future.
Unequal treatment of those without children?
The CEO of the health insurance company DAK-Gesundheit, Andreas Storm, is particularly critical of the increasing burden on those insured without children as a result of the planned reform. This group will be burdened with 3.3 billion euros per year - "more than half of the consolidation volume is attributable to childless people," Storm told the Rheinische Post.
"3.6 percent general contribution and 4.5 percent for childless people - constitutionally we have already reached a questionable dimension here," said Storm. The spread of contributions should not go any further.
The Bochum social researcher Martin Werding defended the controversial higher surcharge for childless people in an interview with BR: "I think this is an important element of our social insurance, which is financed by contributions. So anyone who has children essentially contributes to their long-term financial viability. We only depict that in nursing and I think it can be done."
The bill passed by the cabinet provides for an increase in the contribution surcharge for childless people by 0.3 points to 0.9 percent.
What's next?
According to Health Minister Linnemann, the cabinet will decide on the commission's mandate next week. She should take a fundamental look at the system. "I want a commission in which, as with the issue of health, there are also independent experts and scientists."
His goal is a cabinet decision on their proposals by Easter so that the structural reform can come into force on July 1, 2027, said Linnemann.
