Schwarz-Rot Faces Major Financial Crisis: Health Insurers Anticipate EUR12 Billion Shortfall

Berlin - The coalition government of the Social Democrats (SPD) and the Christian Democrats (CDU) is confronting a significant financial challenge as the funding gap for statutory health insurance (GKV) expands more rapidly than anticipated. In the upcoming year, the health insurers, which cover approximately 74.3 million individuals (90% of the population), are projected to face a deficit of EUR4 billion. This comes despite Finance Minister Lars Klingbeil's plan to provide a EUR2.3 billion loan from the regular federal budget for the 2026 fiscal year.

Looking ahead to 2027, the situation is expected to worsen considerably, with forecasts from the Federal Ministry of Health (BMG) indicating that the shortfall could exceed EUR12 billion. This alarming figure was reportedly a topic of discussion during the coalition negotiations between the SPD and CDU, where party leaders sought to clarify the extent of the financial discrepancies within the budget and social insurance systems. The revelation of such a substantial funding gap has led to concerns about the sustainability of health insurance contributions.

Without significant reforms, this financial shortfall could trigger a sharp increase in health insurance contributions. By 2027, monthly contributions could rise by at least 0.6 percentage points. For individuals earning a gross salary of EUR4,000, this would translate to an additional EUR144 per year in health insurance costs. Currently, the average health insurance contribution stands at 17.5%. Due to the anticipated EUR4 billion deficit in 2026, contributions are already expected to increase by 0.2 percentage points, resulting in a potential contribution rate of 18.3% in 2027.

This rise in costs would not only impose additional burdens on employees but also affect businesses, which cover half of the contributions. The escalating expenses associated with health insurance are likely to overshadow any efforts by the government to alleviate the financial strain on citizens.

Health Minister Nina Warken is aware of the dire projections, which remain confidential for now. The ministry has not confirmed or denied these figures. The Schwarz-Rot coalition is actively exploring strategies to mitigate the financial crisis for insured individuals, with Warken planning to establish a commission tasked with devising comprehensive reforms.

Time is of the essence, as the Federal Court of Auditors has recently urged the budget committee to accelerate reform efforts. The government is required to implement immediate measures in 2026 to address the financial gap anticipated for the following year. Suggestions for closing the funding shortfall include:

• Increasing the contribution assessment ceiling, which currently limits contributions to income up to EUR5,512.50, with discussions of raising this limit to EUR8,000.
• Covering health insurance contributions for recipients of unemployment benefits entirely from the state budget, a measure long sought after by health insurers.
• Requiring all dental treatments to be privately insured, which could generate an estimated EUR17.6 billion.
• Introducing a contact fee of EUR15 for each visit to a doctor's office, potentially saving the health insurance system EUR15 billion.
• Increasing hospital co-payments from the current EUR10 to EUR50 per day, which could save approximately EUR3 billion.

However, Finance Minister Klingbeil faces his own financial dilemmas, with projections indicating a potential EUR22 billion shortfall in the federal budget for 2027, escalating to EUR56 billion in 2028 and EUR66 billion in 2029. Klingbeil has reportedly urged Warken to prioritize structural reforms to maintain stable contribution rates.

The coming months will be crucial as the coalition navigates these pressing financial challenges and seeks viable solutions to ensure the sustainability of the health insurance system.