Overview

• Spending by roughly 90 statutory insurers rose 7.95% to €166.1 billion in H1 2025, led by hospital costs up 9.6% to €54.5 billion, with physician outlays at €27.0 billion (+7.8%) and pharmaceuticals at €28.9 billion (+6%).
• The reported surplus of €2.8 billion is being used to rebuild depleted reserves, which stand at about €4.6 billion, equal to 0.16 months of spending and still below the 0.2‑month legal minimum.
• Health Minister Nina Warken said the GKV is under heavy financial pressure and confirmed there will be no extra discretionary federal funds in the 2025 budget beyond planned loans.
• The government plans repayable loans of about €2.3 billion in 2025 and 2026 and is convening an expert commission this month to deliver reform proposals by spring 2026 on hospitals, emergency care and a primary‑care model.
• The ministry and insurers flag a roughly €4 billion GKV shortfall in 2026 that could put upward pressure on supplemental contributions, even as the coalition reiterates its goal of keeping rates stable and the Schätzerkreis readies its autumn forecast.