Federal Audit Office Issues Warning on Rising Additional Health Insurance Contributions

The Federal Audit Office has raised concerns over the prospect of significantly increased additional contributions for health insurance in Germany. Following a record rise in expenditures last year, the audit office projects that the income of health insurance funds will consistently lag behind their expenses in the coming years. This trend could lead to an annual deficit of billions, resulting in an anticipated increase of approximately 0.3 contribution percentage points each year.

According to a forecast from the Federal Ministry of Health, in a moderate scenario, the additional contribution rate could rise to 4.05% by 2029. This information was derived from a comprehensive 35-page report, which has been cited by various media outlets and is available to the press.

The Audit Office has criticized the federal government for its inaction, suggesting that necessary reforms are being unnecessarily delayed. The government plans to establish an expert commission but has been accused of postponing essential measures to address the rising contributions.

In a statement earlier this year, the Federal Minister of Health indicated that preliminary countermeasures against these increases are necessary even before the outcomes of the planned reform commission are available.

The report highlights that since 2015, the average additional contribution rate has increased from 0.9% to 2.5%, with a total rise of 1.6 percentage points. This escalating financial burden is increasingly affecting both insured individuals and employers, as the overall social insurance contribution rose to 42.3% in 2025, marking an increase of nearly one and a half percentage points.

Annual losses in health insurance are projected to grow by EUR6 billion to EUR8 billion, with spending rising by 8.2% compared to the previous year--this is the fastest rate of increase seen in three decades. As of early 2025, the average additional contributions set by health insurance funds reached 2.9%, exceeding earlier expectations of a rise of 0.8 percentage points.

The overall contribution rate includes a base rate of 14.6%. The situation illustrates the growing gap between revenues and expenditures within the statutory health insurance system, raising questions about the sustainability of the current funding model.