Berlin. Today, the Bundestag is dealing for the first time with the black-red coalition's legislative plans for the financial stabilization of long-term care insurance. The draft by Health Minister Carsten Linnemann (CDU) envisages spending brakes and additional revenue in order to avert general contribution increases in the new year. Time for the consultations is short, as several changes are due to come into force on January 1, 2027.
The German Federation of Trade Unions (DGB) called for improvements. “Instead of further savings, those in need of care and those insured finally need noticeable improvements,” said board member Anja Piel of the German Press Agency. Some unreasonable demands have been removed, for example with regard to initially planned cuts in pension payments for caring relatives. However, this does not solve the risk of poverty in care. One of the most important points now is a cap on personal contributions.
The federal government's care representative, Katrin Staffler (CSU), warned of further burdens for caring relatives. They have a 24-hour job and need freedom, she told “Bild”. So far, preventative care has been helping. “If it is lost in its flexible form, it will hit caring relatives particularly hard.”
The law is initially intended to address acute financial needs. A commission of experts will soon provide suggestions for a comprehensive reform. The background is ever-increasing expenditure, now amounting to 74 billion euros per year. Unlike health insurance, long-term care insurance only covers part of the costs of care, and those affected have to pay their own contributions. In the home there are additional costs for accommodation and other items.
The cabinet launched the draft at the end of September - after wrangling until the last minute. Now it is the coalition factions' turn, and some further changes are already on the horizon.
The most recent general contribution increase came by 0.2 points at the beginning of 2025. The contribution for one child is now 3.6 percent of the gross wage; for people without children there is a surcharge of 0.6 points. This is to be increased to 0.9 points on January 1, 2027, so that the childless contribution rises to 4.5 percent. This should bring in additional revenue of 3.3 billion euros. From 2028, employers will also have to pay care contributions for mini-jobbers.
As with statutory health insurance, high earners should be given greater consideration. To this end, the monthly salary limit up to which care contributions are due is to be increased by an additional 300 euros in 2027. From 2028, free co-insurance for spouses is to be restricted. It should remain for children, parents of children under twelve and of children with disabilities, for people with relatives in need of care and of normal retirement age. For other people who are still insured for free, the family member paying the premium should then pay a surcharge of 0.52 percent.
The benefits of long-term care insurance should no longer be adjusted from time to time by law. There should be annual increases based on inflation developments, but only from 2029. This should provide long-term security for those in need of care and curb the increase in personal contributions. In return, an increase in benefits due under current law for 2028 will no longer apply.
A reform from 2017 is considered a key reason why the number of benefit recipients rose rapidly to six million. Criteria for determining a need for care, which were greatly expanded at the time, are now to be narrower for new classifications - as recommended by experts at the time. According to the ministry, comprehensive inventory protection applies. Nobody will lose their recognized level of care because of new thresholds.
There are individual support services for care at home that should be bundled in new budgets. For care levels 2 to 5, there will in future be a “social space budget” to finance everyday assistance - namely up to 175 euros per month from the age of 25 and up to 300 euros for younger people. You should also be able to pay for replacement care from another budget if the person caring for you is on vacation or is sick. The “preventative care” that has previously served this purpose should no longer be a separate service.
The focus is also on greater avoidance of the need for care. For care at home, there should be a right to “care support” from professional staff in order to detect health deteriorations earlier. For the lightest care level 1, the previous relief amount of up to 131 euros per month should no longer apply. Insured people aged 60 and over should be entitled to preventive examinations specifically for age-related diseases.
A federal subsidy of one billion euros per year for long-term care insurance that was once introduced has already been suspended for 2024 to 2027. Now it will not be paid in 2028 either. In 2029, 500 million euros should flow and from 2030 onwards one billion euros annually as a permanent regulation.
