Germany’s statutory health insurance system (GKV) is heading into 2025 with a significant financial challenge: a budget gap of at least €4 billion.
According to early reports, the Federal Ministry of Health is working on reforms designed to stabilize contributions while avoiding direct cuts to benefits for the insured.
The initiative is being led by Health Minister Nina Warken (CDU) and her state secretary Tino Sorge (CDU). Both politicians argue that contribution hikes cannot remain the only solution.
Instead, they are developing what some are already calling a “health insurance revolution.”
Base tariff with optional add-ons
State Secretary Sorge suggested that every statutory health insurer could offer a low-cost base tariff in the future.
This would reduce the average contribution rate (currently around 17.7%). Patients would then have the option to book additional coverage modules for an extra fee.
Sorge explained: “Funds could offer a solid basic package at a lower cost, while giving people the choice to add tailored extras.”
Such extras might include services not universally covered today, such as vision care or glasses. Importantly, Sorge stressed that no insured person would face a reduction in essential protection under the model.
This approach could give consumers flexibility:
- Those wanting to save would stick with the base tariff.
- Those seeking extended services could buy additional packages.
Primary care model as another cost lever
The CDU concept also revives the coalition agreement’s plan to introduce a primary care physician model.
Patients who first consult their family doctor before seeing a specialist could benefit from cheaper tariffs.
According to Sorge, this would create incentives for structured care and potentially lower system-wide costs.
Support and concerns from experts
Health economist Prof. Andreas Beivers (Fresenius University of Applied Sciences) welcomed the proposals as steps toward greater personal responsibility in the health system.
However, he cautioned against social risks: reforms must ensure that low-income groups can still afford free choice of doctors and adequate coverage.
What happens next
The proposals will now be discussed with coalition partners in the SPD over the coming weeks.
With statutory health insurance contributions already among the most significant payroll costs in Germany, the CDU is under pressure to show that reforms can prevent further steep increases.
As Sorge put it: “Continuous contribution hikes are not a sustainable solution.”
