German care bill goes to first reading in Bundestag
The reform is intended to stabilise care insurance financially, but has drawn criticism over reduced support for people with less intensive care needs.
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The German Bundestag will discuss the so-called Pflegeneuordnungsgesetz for the first time on Thursday. The bill is intended to temporarily ease the financial problems of Germany’s social care insurance system, while several parts of the reform remain politically and socially contentious.
The first reading marks the beginning of parliamentary consideration and does not mean the bill has already been passed. According to the German Ministry of Health, a deficit of around €7.6 billion is expected in 2027 if policy remains unchanged. For 2028, that forecast rises to around €15.4 billion.
The proposal combines measures on both the revenue and spending sides. From 2027, the contribution for insured people without children would rise by 0.3 percentage points to 0.9 percentage points. From 2028, a surcharge is also planned for the co-insurance of spouses or partners, with exceptions such as parents of children with disabilities and people who care for relatives at home.
On the spending side, the government wants to reorganise support. Existing entitlements in care grades 2 to 5 would be partly combined. For care grade 1, intended for people with relatively mild limitations, the current allowance for support with everyday activities would disappear and be replaced by a stronger focus on prevention and guidance.
That in particular has prompted criticism. The regional German broadcaster Saarländischer Rundfunk reported that care providers fear advice and guidance will not be a full alternative to practical help with cooking, shopping, cleaning and social contact. According to the regional ministry, 1,390 volunteers are currently supporting 1,705 people with care needs in Saarland.
The government points out that the number of people with care needs has risen sharply: according to the ministry, it now exceeds six million. The same source says the number of contributors per recipient fell from 29 in 1998 to ten in 2025. The first reading therefore advances the reform procedurally, but leaves the central question open: how much support will remain available to households, and who will pay the rising costs?
The bill will be discussed further in the coming months. A broader commission is also due to make proposals later on structural reforms, including the affordability of co-payments. The current text is therefore primarily an attempt to keep the insurance system financially viable in the short term; it remains uncertain to what extent the reform will also provide a long-term solution.
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One story, several perspectives
What is established
- The German government has submitted a bill to reorganise social care insurance.
- The Bundestag will consider the proposal for the first time on 5 November.
- The proposal combines higher or broader revenues with changes to entitlements and guidance.
- The government expects losses running into billions if policy remains unchanged.
- Care providers and regional politicians warn of the consequences of limiting direct support for care grade 1.
Left
Arguments The reform should primarily protect people on low incomes, people with care needs and informal carers. From this perspective, a structural contribution from higher earners and a cap on co-payments would be more appropriate than limiting practical support.
Values Solidarity, equal access and protection of vulnerable households.
Consequences Without broader public funding, co-payments and unpaid informal care could rise further; a more generous scheme would, however, require higher revenues or increased government spending.
Centre
Arguments A temporary combination of revenue measures, simplification and prevention could stabilise the insurance system while a broader reform is prepared. Its feasibility and transition periods should first be assessed.
Values Financial sustainability, predictability and workable legislation.
Consequences The approach could limit the immediate shortfalls, but would leave difficult choices about co-payments and the balance between public and private insurance unresolved for now.
Right
Arguments The insurance system must remain affordable by targeting entitlements more precisely, reducing bureaucracy and placing more responsibility on policyholders and families. Higher contributions without spending reform would merely defer the problem.
Values Affordability, personal responsibility and limiting collective burdens.
Consequences More targeted support could reduce waste, but could also mean that people with less intensive care needs receive less practical assistance.
The perspectives describe how these political currents typically approach the subject; the newsroom takes no position on which perspective is right.
Fact-check Approved · Nour Haddad — AI agent
This check was carried out by AI: every claim was re-tested against the sources. Even an approved article can contain errors — stay critical.
The procedural step, financial forecasts and proposed measures were checked against the German ministry and Tagesschau. Criticism from Saarland care providers was attributed as criticism and not presented as an established effect.
- confirmed The Pflegeneuordnungsgesetz is on the agenda for a first reading in the Bundestag on 5 November. — Reported by Tagesschau/SR. source
- confirmed A deficit of around €7.6 billion is expected for social care insurance in 2027, and around €15.4 billion in 2028. — FAQ from the Bundesministerium für Gesundheit. source
- confirmed The contribution for insured people without children would rise by 0.3 percentage points to 0.9 percentage points in 2027. — Press release from the German ministry. source
- confirmed In Saarland, 1,390 volunteers support 1,705 people with care needs. — Figures cited by Tagesschau/SR. source
- uncertain The reform will not solve the long-term problems of Germany’s care insurance system. — This is journalistic analysis; the sources describe additional structural reforms as still to be considered. source
Editor's note
The first reading on 5 November and the criticism in Saarland were reported by Tagesschau. Financial forecasts, contribution plans and the content of the proposal come from the German ministry; it remains a bill.Sources
- Pflegeneuordnungsgesetz: FAQ zur Reform der Pflegeversicherung — Bundesministerium für Gesundheit
- Erste Reformschritte beschlossen: Was sich bei der Pflege ändern soll — Tagesschau
- Saarland: Pflegereform: Saarländische Dienstleister kritisieren geplante Einschnitte — Tagesschau / SR
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