German Care Reform Stalls as Costs for Patients Climb and Unions Cry Foul
Published on 07/14/2026 at 17:58 | Redaktion boerse-global.de
Nursing home residents in Germany are facing higher out-of-pocket expenses after a planned overhaul of the long?term care system ran into political delays. The draft legislation, known as the Care Reorganisation Act (PNOG), was supposed to be debated by the federal cabinet in mid?July, but the meeting was postponed. Sources now point to either 22 or 29 July as possible dates, with a first reading in the Bundestag unlikely before autumn.
The bill, drawn up by Health Minister Warken, requires nursing care funds to save €2.6 billion by 2027. One key measure would stretch the duration of relief surcharges for home residents from 12 to 18 months per stage. At the same time, contributions to pension insurance for family carers could be reduced.
Already, the average monthly out?of?pocket cost for care in a nursing home during the first year stood at €2,088 as of 1 July. From 2027, the €131 monthly relief payment for people with care grade 1 will be scrapped altogether. For care grades 2 to 5, a new “social?space budget” will apply, ranging from €175 to €300 per month depending on age.
Union warns of tariff wage freeze and benefit cuts
The trade union ver.di has sounded the alarm over what it calls “significant deteriorations” for both care recipients and staff. Particularly controversial is the plan to suspend the mandatory tariff wage obligation for four years. ver.di also criticises the short consultation period for associations and the proposed increase in threshold values used to assign care grades, which would make access to benefits harder.
Instead, the union demands a stronger focus on revenue. It calls for extending compulsory contributions to all types of income, introducing a financial equalisation between private and statutory long?term care insurance, and requiring the federal government to take over non?insurance?related benefits worth €4.5 billion annually – plus €6 billion in outstanding pandemic aid.
New health insurance law fuels further anger
Parallel disputes have erupted over the Health Insurance Contribution Rate Stabilisation Act, passed on 10 July. The German Nursing Council (DPR) and the German Professional Association for Nursing Professions (DBfK) strongly criticise the cap on nursing budgets. Most contentious is the departure from binding nursing staff measurement (PPR 2.0).
DBfK president Vera Lux warns that the move could trigger job cuts reminiscent of 1996 and 1997, endangering patient safety and putting staff under pressure. The German Hospital Association (DKG) and the employers’ association bpa have joined the criticism.
Another flashpoint is the refinancing of tariff increases. Providers bound by collective agreements receive full reimbursement for salary hikes up to a certain ceiling, while non?unionised facilities get nothing. The bpa is considering a constitutional complaint, arguing that this distorts competition. The National Association of Statutory Health Insurance Funds defends the measures as necessary to stabilise contribution rates. Some hospital groups have even welcomed the deregulation. For care recipients and employees, however, the situation remains tense.
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