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Germans Brace for Health Insurance Overhaul as Coalition Splits Over Possible Benefit Cuts

Fiscal strain is pushing Berlin to pair a commission review with immediate hospital savings, heightening expectations of higher patient co-payments.

Overview

  • A YouGov survey for DPA finds 81% expect higher co-payments and 74% anticipate fewer services covered by statutory insurance.
  • Health Minister Nina Warken has a January 1 savings package targeting up to €2 billion in hospital costs, with 2026 spending projected at about €370 billion—€23 billion more than 2025—and a financing gap expected in 2027.
  • An expert commission is due by March 2026 to propose measures to stabilize financing from 2027, with broader reform options to follow by the end of 2026.
  • Tensions inside the CDUSPD government sharpened after Kanzleramtsminister Thorsten Frei raised the prospect of service cuts, which SPD health chair Tanja Machalet rejected as she urged waiting for the commission’s findings.
  • Options under discussion include raising medication co-payments from €5–€10 to €7.50–€15 and fees for direct specialist visits, while insurers seek higher federal transfers and are suing over an alleged €10 billion shortfall; Warken supports steering elements but opposes a new general practice fee.