Overview
- The Bundestag and the Bundesrat approved the package on Friday, July 10, 2026, with the Bundestag recorded vote 319 yes, 286 no and 4 abstentions, allowing the law to enter into force.
- Key changes include higher one‑off co‑payments for medicines and hospital stays, tighter rules on free family insurance from 2028 with a possible 2.5% surcharge for some partners, limits on pay increases for doctors and hospitals, and a fixed additional manufacturer rebate for drugs.
- The law mandates a new partial sick‑leave scheme that lets doctors prescribe 25%, 50% or 75% work capacity with proportionate wage and partial Krankengeld, requires new digital reporting by employers and insurers, and will be evaluated after one and five years; rollout is planned from 1 July 2028.
- Legislators raised the 2027 savings target to about €18.8 billion and increased federal transfers compared with earlier plans to close most of the financing gap while keeping some cuts to the regular federal subsidy smaller than first proposed.
- Opposition parties, medical groups and hospital associations warn the measures could strain access and provider viability, critics challenged the fast timetable at the constitutional court without success, and the government says it will monitor results and pursue further reforms after the summer break.