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Germany Pushes Care Overhaul as Trust Slides and 2026 Funding Gap Weighs

The government is steering toward a prevention‑focused 2026 reform alongside negotiations on a loan top‑up to stabilize contributions.

Overview

  • A new Allensbach survey for DAK finds 62% rate long‑term care as not good or very bad, with the insurer warning the system is at a tipping point.
  • Insurers face a roughly €1.7 billion shortfall in 2026; Berlin has already provided a €1.5 billion loan, and coalition budget negotiators and health officials signal a top‑up is likely.
  • Health Minister Nina Warken announced a “new overall concept” with expert groups on financing and provision, reaffirmed near‑term contribution stability, and backed a bill to expand nursing autonomy and cut red tape.
  • A Bund‑Länder report rejects abolishing Pflegegrad 1 and points to redesigning support for low‑need people toward prevention and rehabilitation, with the assessment criteria set for review.
  • Costs and staffing pressures persist, with average monthly out‑of‑pocket payments in care homes at about €3,108, heavy documentation burdens on staff, growing reliance on foreign workers, and intensifying debate over deregulation versus broader, solidarity‑based financing.