Germany’s Nursing Care Fix Targets High Earners and Minijobbers as €7.6 Billion Deficit Looms

Germany's nursing care insurance faces €7.6B deficit by 2027; new law raises contributions for high-income and childless workers while cutting benefits, sparking criticism.

Germany’s statutory nursing care insurance is on course for a €7.6 billion deficit in 2027, rising to €15.4 billion a year later, according to a draft law published by the Federal Ministry of Health. Rather than raise the general contribution rate, Health Minister Nina Warken wants to spread the burden selectively — hitting high-income employees, childless workers, and employers of minijob workers, while cutting benefits for the care-dependent.

About six million people will see their contributions rise from 2027, the first full year the Nursing Care Reorganisation Act (PNOG) takes effect. The contribution assessment ceiling, the income level up to which contributions are calculated, will be raised to match the health insurance ceiling. That translates into roughly €300 more in the monthly assessment base, costing top earners up to €17 extra a month. Employers will also pay a correspondingly higher share.

Childless workers face a steeper surcharge, from 4.2% to 4.3%. From 2028, the ministry plans to introduce a 0.52% contribution surcharge for the previously contribution-free spousal co-insurance. In a first for the mini-job sector, employers will have to pay a 3.6% care contribution.

On the spending side, the draft law demands deep cuts. Stricter criteria for assessing care grades are expected to save around €1.3 billion in 2027. Residents in nursing homes will wait longer for subsidies toward their out-of-pocket costs; staggering the subsidy scale is forecast to relieve the fund by another €2.6 billion in the first year. Pension contributions paid by the insurance for caring relatives will drop to 70% of the current level, saving €1.8 billion to €2 billion annually.

Yet the government also pledges investment: €1.6 billion from a special infrastructure fund will go toward digitising long-term care, and from 2028 benefit amounts are to be adjusted annually.

Sharp criticism has come from local authorities and care associations. Burkhard Jung, president of the German Association of Cities (Städtetag), warned that service cuts would push more people onto social assistance, simply shifting costs from social insurance to municipal budgets. The German Nursing Council (Pflegerat) called the reform a “pure austerity programme” that loads the burden onto care recipients and families. North Rhine-Westphalia’s health minister, Karl-Josef Laumann, also condemned the planned suspension of the collective-bargaining commitment rule for care homes, saying it endangers fair pay.

In a flanking measure, the ministry is examining whether to lower the income threshold for children’s obligation to pay for parents’ care costs. Currently, children must contribute only if their gross annual income exceeds €100,000. Reducing that level would hit the upper middle class but relieve municipalities of some social-assistance spending.