German Health Overhaul Raises Ceilings and Slashes Spousal Coverage to Close €19 Billion Gap
14.06.2026 - 00:32:46 | boerse-global.de
Germany’s statutory health-insurance system faces a projected €19 billion shortfall by 2027, prompting the government to push through a package of measures that will hit high earners, their spouses, and eventually all insured members. The draft law — formally named the GKV-Beitragssatzstabilisierungsgesetz — had its first reading in the Bundestag on June 12.
At the centre of the reform is a sharp increase in the contribution assessment ceiling (Beitragsbemessungsgrenze, BBG). Starting now, that limit rises by €300 a month. Instead of the previous €69,750 annually, workers will pay contributions on income up to around €76,350 per year. Parallel to that, the income threshold for compulsory insurance (Jahresarbeitsentgeltgrenze, JAEG) will climb to roughly €84,800 by 2027.
For childless, voluntarily insured members, the combined changes will mean extra costs of up to €119 per month. Moreover, the higher JAEG makes it harder to switch to private health insurance (PKV). Anyone who wants to leave the statutory system now needs a significantly higher minimum income to qualify.
Health Minister Warken justified the overhaul by pointing to the €19 billion shortfall forecast for 2027. Even with the planned measures, she acknowledged a gap of €3.5 billion would remain that year. “Stabilising contribution rates remains our priority,” she said. But the numbers show a clear upward trend: the average additional contribution (Zusatzbeitrag) rose from 1.7% to 2.5% in 2025, and experts predict it will hit 2.9% in 2026. The Knappschaft health fund is already imposing increases of up to 1.6 percentage points. The general statutory contribution rate stays fixed at 14.6%.
One of the most controversial elements is the near-abolition of contribution-free family insurance for spouses and registered partners. Exceptions will apply only to partners who are raising children under seven, providing care services, or have reached the standard retirement age. All other partners will pay a surcharge equal to the average additional contribution — currently 2.5%.
On top of that, co-payments for insured members are set to rise by about 50%. The Bundesrat voiced strong criticism on June 12. The upper house warned that hospitals — which have already contributed €1.8 billion to stabilisation — face additional burdens and called instead for reforms targeting the pharmaceutical industry and hospital structures.
Beyond health insurance, long-term contribution increases are also emerging in pensions. The contribution rate will remain at 18.6% until the end of 2027, then jump to 19.9% in 2028 and 20.0% in 2029. The main driver is demographics: the ratio of working-age people to retirees is expected to drop from 2.5 to 1.9.
In nursing-care insurance, the rate already increased at the start of 2025 from 3.4% to 3.6%, plus a childless surcharge of 0.6%. The assessment ceiling here mirrors the health-insurance one at €5,512.50 per month.
For employers and payroll departments, the rising thresholds mean more checking, especially for workers with multiple jobs. If cumulative earnings exceed any given BBG, the pay must be proportionally reduced for contribution calculations. The due date for total social-security contributions remains unchanged for 2026: the third-to-last banking day of the month.
