German Parliament Weighs Graduated Sick Leave as Health Insurers Face €15 Billion Hole
11.06.2026 - 03:06:50 | boerse-global.de
The binary choice between being fully fit for work or entirely off the sick list may soon be a thing of the past in Germany. The Bundestag is set to hold its first reading of legislation on 12 June 2026 that would allow doctors to certify incapacity in graduated steps — 25, 50 or 75 percent — rather than requiring a blanket medical note.
The proposal, tucked inside the wider GKV-Beitragssatzstabilisierungsgesetz (Statutory Health Insurance Contribution Rate Stabilisation Act), draws heavily on Nordic models that have long permitted phased returns to work. It targets employees whose illnesses drag beyond four weeks, a group that includes many people recovering from surgery or managing chronic conditions. Mental health disorders, the most common trigger for long-term incapacity in Germany, are expected to be a primary application.
Under the plan, a doctor would need to confirm both a reduced capacity to work and the patient's subjective sense of being able to handle partial duties. The employer then gets seven days to review the medical certificate and approve the arrangement. Only with the company's green light does the partial leave take effect.
Savings of €160 Million a Year by 2030
The financial logic driving the change is straightforward: when an employee works, the employer pays wages for those hours, and the health insurer stops paying sickness benefit (Krankengeld) for that portion. Projections show the model saving the statutory health insurance (GKV) system roughly €40 million in 2027, climbing to €160 million annually by 2030.
Those sums are modest compared with the system's overall deficit. The GKV posted a shortfall of nearly €10 billion in 2024, and without corrective measures the gap is expected to widen to €15 billion by 2027. The partial-incapacity rule is one element of a larger reform bundle designed to close that chasm.
Broader Belt-Tightening Kicks in Next Year
The cabinet already dropped a previously floated across-the-board cut to sickness benefit, which would have reduced it from 70 to 65 percent of salary. That proposal was scrapped at the end of April 2026. But other tightening measures remain in the draft.
From 1 January 2027, if an employment contract ends while a worker is still on sick leave, the sickness benefit will be capped at the level of unemployment benefit I (around 60 percent of net pay for most claimants). The deadline for applying for rehabilitation benefits will also be slashed from ten weeks to just four.
Another revenue-raising provision would introduce a 2.5 percent surcharge on the income of members whose spouses are currently co-insured for free, effectively ending that subsidy.
The government is pushing to pass the entire package before the summer parliamentary recess in 2026, giving insurers and employers a six-month runway to implement the changes by the start of 2027. For the millions of Germans caught in an extended bout of illness, the transition could mean a gradual return to work — and for the health system, a gradual return to solvency.
