(de-news.net) – With stricter eligibility requirements, updated benefits, and increased contributions for specific groups, Germany’s long-term care insurance reform is intended to solve an estimated 8 billion euro deficit in 2027. During the first parliamentary debate on Thursday about the planned care reforms, opposition parties warned of reduced assistance, additional costs, and insufficient financial relief for caregivers, while coalition officials propose structural modernization and legislative changes.

In order to overcome a projected multibillion-euro shortfall, the Federal Government intends to restructure long-term care insurance by altering eligibility requirements, benefits, and payment rates. While opposition parties caution that the planned changes could add financial and administrative costs, Health Minister Carsten Linnemann has pledged to amend the Act to prevent interruptions for care recipients.

Carsten Linnemann, the Minister of Health, said that demographic shifts and earlier policy choices were putting a lot of strain on the long-term care insurance system. Despite characterizing the planned legislation as an early emergency measure, he promised changes after consulting with the parliamentary groupings of the governing coalition. The transition plans for relief allowances and replacement care, which offer short-term support when regular caregivers are absent, would receive special consideration. Linnemann stressed that while upholding the Government’s commitment to cutting spending and avoiding abuse, vulnerable people shouldn’t experience sudden disruptions when the primary measures go into effect at the start of the year.

The Minister also reaffirmed his goal to improve home-based care, claiming that because family situations varied greatly, its worth could not be fairly assessed using financial metrics. Although the system will need to more efficiently distribute existing resources, he insisted that anyone in need of aid should still get it.

CDU/CSU urges modernization as SPD seeks other changes

The health policy spokesman for the CDU/CSU parliamentary group, Simone Borchardt, also favored structural modernization above ongoing funding increases. She contended that certain elements of the system were founded on institutional arrangements that date back four or five decades in an interview with the television channel Phoenix, a public broadcaster. She stated that while individual benefit cutbacks might happen, they shouldn’t take center stage in the overhaul. To guarantee sufficient assistance for individuals receiving care at home, the planned transitional and community-based care budgets would also need to be discussed in parliamentary deliberations.

The legislation is one of the most significant reforms of the current legislative period, according to Dagmar Schmidt, deputy chair of the SPD parliamentary group. However, he also pointed out some unresolved issues, especially with regard to the planned elimination of substitute care arrangements and the restructuring of benefits. Additional complaints were voiced by opposition representatives. Simone Fischer, a spokesperson for the Green Party’s health policy, warned that significant financial gaps would still exist despite the proposed tightening of eligibility conditions for care grades one through three. AfD health policy representatives contended that the measures would result in higher expenses and disadvantages for insured citizens, while the leadership of the Left Party demanded more financial support for family caregivers.

Changes to eligibility and home-care benefits

With a projected shortfall of almost 8 billion euros in 2027 if quick action is not taken, the changes are meant to solve the long-term care insurance system’s declining financial situation. Higher contributions for childless workers, a higher income maximum for contribution calculations, limitations on free spousal coverage, and more stringent eligibility requirements for the first three care grades are some of its main initiatives. Preventive services would be increased, and home-based care benefits would be rearranged. Previous plans to lower family caregivers’ pension benefits have been shelved.

In 2017, the current five-level care classification system was implemented. However, the Government revised the assessment system because the initial criteria were not in line with scientific advice. As a result, access to care for grades one, two, and three will become more limited. People who were already given a care grade prior to the new law’s implementation will keep their current categorization.

The majority of those in need of long-term care are cared for at home. A monthly relief grant of 131 euros, which can cover services like household assistance, is provided by care funds under the current system. Recipients in care grade one will no longer be eligible for this benefit. Instead, a portion of the funds will be used to fund a professional care guiding service that would give recipients and their families early counsel and useful assistance. 2029 is when the service is expected to start.

In order to continue providing support during sudden or severe disruptions, a transitional care budget is also envisaged. While short-term residential care would be accessible starting in 2028, outpatient care providers would be able to step in. In a broader sense, flexible budgets would be combined with individual home-care benefits. Insurance benefit amounts for residential and outpatient care would rise yearly in accordance with inflation starting in 2029.

Residential care and contribution adjustments

Gradual insurance payments would continue to partially defray the cost of full-time residential care. For the first year, these now pay 15% of qualified care-related personal expenses; after 12 months, they increase to 30%, after 24 months to 50%, and after 36 months to 75%. The Government plans to keep this tiered structure, in contrast to previous recommendations. Higher-income contributors and employees without children would be the main recipients of contribution hikes. Currently 0.6 percentage points more than the basic employee rate of 1.8 percent, the supplementary contribution rate for individuals without children would increase to 0.9 percentage points.

Additionally, the bill would limit couples without significant independent income from obtaining contribution-free insurance coverage. Affected individuals would be required to contribute 0.52 percent of their partner’s assessable income starting in 2028. Children, parents of children under the age of twelve or children with disabilities, caregivers for dependent family members, and adults who have reached the legal retirement age would still be exempt. Additionally, individuals with negligible part-time jobs would have to make contributions. The monthly contribution assessment cap would also rise by 300 euros, increasing payments to employers and higher-income workers who continue to participate in the statutory insurance system.

Linnemann announced that additional significant structural adjustments would be required to ensure the system’s long-term stability and described the legislation as an initial emergency intervention. As a result, the governing coalition has assigned an expert group to create recommendations for a thorough overhaul of long-term care. The Minister stated that the Cabinet should preferably approve its recommendations prior to Easter.