Overview

• The Bund-Länder commission convened on July 7 to draft a comprehensive package of reforms after the Bundesrechnungshof highlighted long-term funding shortfalls in social care insurance
• The Federal Ministry of Health projects a €3.5 billion deficit in 2026 and a cumulative financing gap of €12.3 billion by 2029 for the statutory care insurance
• Budget plans include state loans of €0.5 billion in 2025 and €1.5 billion in 2026, measures that auditors warn will only provide temporary relief
• Labor unions and patient advocacy groups are calling for caps on out-of-pocket payments and renewed tax subsidies, while employers and some state governments propose benefit cuts and private-sector solutions
• Commission members aim to agree on a “Zukunftspakt Pflege” by year-end to secure sustainable financing amid a rising number of care-dependent members