(de-news.net) – Germany’s planned long-term care reform seeks to reduce system deficits by delaying subsidy increases, tightening eligibility criteria, and raising contributions, thereby shifting more costs onto beneficiaries and certain contributors.
Federal Health Minister Nina Warken (CDU) is planning a long-announced long-term care reform that would, in its current conceptualization, increase the financial burden on residents of nursing homes while simultaneously attempting to address and partially close significant financing gaps within the statutory long-term care insurance system. These intentions are reflected in draft ideas that have been circulated within coalition circles, suggesting an early-stage but directionally clear policy framework. According to reports, the plans are designed to generate savings amounting to billions of euros, in part through adjustments to existing qualifying requirements as well as to the structure and timing of subsidy arrangements.
A central component of the reform involves decelerating the rate at which progressive subsidies—granted to residents to offset out-of-pocket expenses—are increased over time. Under the proposed model, each subsidy tier would only take effect after eighteen months, rather than the current twelve-month interval, thereby extending the waiting period before beneficiaries can access higher reimbursement levels. In practical terms, this means that individuals would face a longer duration of comparatively higher personal financial contributions before qualifying for increased support. The revised schedule would retain the 15 percent subsidy for the first 18 months, followed by a transition to a 30 percent rate; subsequent increases to 50 percent and ultimately 75 percent would be postponed to 36 months and more than 54 months of residency, respectively, replacing the shorter progression intervals currently in place. This restructuring is anticipated to produce substantial cost savings for the insurance system by delaying expenditure growth over time.
Higher contributions aim to reinforce system financing
Concurrently, access to benefits would likely become more restrictive under the proposed framework. Draft provisions indicate that formal recognition as care-dependent would require meeting a higher threshold of disability, particularly with regard to assignment to lower care grades (levels 1 through 3). Observers note that tightening these eligibility criteria could significantly reduce the number of individuals who qualify for benefits, thereby further decreasing overall system expenditures. This shift reflects a broader effort to recalibrate both eligibility and benefit distribution in order to stabilize financing.
Another policy under consideration involves transferring limitations on contribution-free family co-insurance—currently a feature of the health insurance system—into the long-term care insurance domain. Under these proposals, spouses who do not have young children or caregiving responsibilities would be subject to an additional contribution of 0.7 percent, introducing a new financial obligation for this group. Furthermore, the contribution assessment ceiling for higher earners would be raised, aligning long-term care financing more closely with recent adjustments made in statutory health insurance. Taken together, these measures illustrate a comprehensive attempt to rebalance the system through a combination of expenditure restraint and revenue enhancement, albeit with notable implications for beneficiaries and contributors alike.
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