(de-news.net) – Significant changes to statutory health insurance, energy policy, federal policing, and parliamentary remuneration have been passed by the German Bundestag. Significant political and industry-wide opposition was sparked by the measures to reduce healthcare costs. What is more, provisions to amend heating standards, halt parliamentarians’ automatic salary increase, and boost the Bundespolizei’s investigative authority have been passed.
By a vote of 319 to 286, with four abstentions, the Bundestag approved the controversial Contribution Rate Stabilization Act, a coalition-backed reform of Germany’s statutory health insurance system (GKV). Although the legislation did not require formal approval by the Bundesrat, the upper chamber subsequently allowed it to proceed rather than delaying its implementation by referring it to a mediation committee, thereby clearing the way for the reform package to take effect.
The legislation is intended to stabilize the finances of the statutory health insurance system by bringing expenditure growth more closely into line with revenue while preventing additional increases in insurance premiums. During the parliamentary debate, Health Minister Nina Warken argued that the deteriorating financial position of the statutory health insurers required immediate legislative action and described the package as the first stage of a broader restructuring of Germany’s healthcare system. Members of the governing coalition similarly maintained that the measure represented only an initial step and that further structural reforms would follow in subsequent legislative initiatives.
The government projects that the Act will generate savings of 18.8 billion euros by 2027, exceeding earlier cabinet estimates after healthcare expenditures increased more rapidly than anticipated during the first months of the year. The reforms introduce cost-saving measures affecting patients, healthcare providers, insurers, pharmacies, and the pharmaceutical industry simultaneously. For patients, prescription drug co-payments will increase from 5–10 euros to 7.50–15 euros, representing the first adjustment in 22 years. Statutory reimbursement for homeopathic treatments will be eliminated, while coverage for selected preventive services—including routine skin cancer screening for asymptomatic adults—will either be reduced or subjected to further review. Reimbursement for dental prostheses will likewise be lowered, reflecting the legislation’s broader objective of limiting expenditure on benefits that the government considers less essential.
Health reform tightens benefits, provider funding, and administrative spending
Eligibility for contribution-free family insurance will also become more restrictive. Children, pensioners, individuals with reduced earning capacity, caregivers, and parents of young or disabled children will continue to qualify for exempt coverage, whereas most spouses and registered civil partners will instead be required to obtain their own insurance, with a separate contribution scheduled to take effect beginning in 2028. In addition, higher-income earners will face an increase in the contribution assessment ceiling, thereby expanding the share of income subject to statutory health insurance contributions.
Healthcare providers will also be subject to stricter expenditure controls under the legislation. Hospitals will lose provisions that previously permitted reimbursement to grow more rapidly, physician practices will no longer receive certain extra-budgetary payments, and reimbursement growth will generally be tied more closely to increases in insurers’ revenues. The reforms also introduce mandatory second medical opinions before selected orthopedic procedures involving the knee, hip, spine, and shoulder in an effort to scrutinize surgical necessity more closely. Pharmacies and pharmaceutical manufacturers will face more stringent rebate requirements, including expanded substitution of lower-cost medicines where appropriate. At the same time, administrative and advertising expenditures by statutory health insurers will be capped, although consumer advocates criticized the removal of the requirement that insurers directly notify policyholders of increases in supplementary premiums. No legislative provisions addressing psychotherapeutic care were included in the Act, with the governing coalition instead indicating that non-binding proposals on the issue would be presented after the summer recess.
Opposition parties, hospitals, medical associations, trade unions, and social welfare organizations continued to criticize the legislation, arguing that it transferred financial pressure to patients and healthcare providers instead of addressing the structural causes of rising healthcare costs. Parliamentary opponents characterized the package as inadequately prepared and argued that it would impose additional burdens on approximately 75 million people covered by the statutory insurance system. Critics further warned that the reforms could accelerate hospital closures, worsen workforce shortages, reduce access to medical services, and contribute to longer waiting times for treatment. Before the vote, Green and Left Party lawmakers sought unsuccessfully to postpone parliamentary consideration on procedural grounds, arguing that legislators had not been given sufficient time to examine extensive amendments; however, the Federal Constitutional Court rejected those legal challenges.
Germany adopts energy policy, pay freeze, and Federal Police authorities
In a separate vote, the Bundestag approved amendments to the Building Energy Act that repeal the existing requirement for newly installed heating systems to operate using at least 65 percent renewable energy. Under the revised framework, new gas- and oil-fired heating systems will remain permissible provided that they progressively incorporate climate-neutral fuels such as biomethane. The previously planned prohibition on operating fossil fuel heating systems beginning in 2045 will also be removed. At the same time, a renewable gas quota for existing heating systems is scheduled to begin in 2028, while subsequent implementing legislation will require suppliers of gas, oil, and liquefied petroleum gas to transition entirely to climate-neutral fuels by 2045. Environmental organizations together with opposition parties argued that these changes represented a significant setback for Germany’s climate policy objectives.
Parliament also voted unanimously to suspend the automatic annual increase in its members’ salaries for one year. Under the adjustment mechanism introduced in 2014, parliamentary remuneration would otherwise have increased by 4.2 percent in line with nominal wage growth. The governing coalition argued that the country’s difficult fiscal and economic circumstances justified an exceptional departure from the statutory adjustment formula despite continued wage growth, although a proposal to freeze parliamentary salaries throughout the current legislative term was rejected.
In addition, the Bundestag enacted a new Federal Police Act expanding the investigative powers of the Bundespolizei. The legislation authorizes the use of camera-equipped drones in criminal investigations and permits artificial intelligence-based analytical systems capable of integrating and evaluating information drawn from multiple databases, thereby broadening the federal police’s technological capabilities in combating crime.
