Germany's health reform faces pushback over sick pay cuts and dependent coverage

North Rhine-Westphalia's Health Minister Karl-Josef Laumann has called on his federal counterpart, Nina Warken (both CDU), to revise key aspects of the planned reform of Germany's statutory health insurance system (GKV). While Laumann welcomes the revenue-based spending policy, he is demanding additional federal funding to ensure adequate coverage for citizens receiving basic welfare benefits (Bürgergeld).

"For years, the federal states have emphasized that financing for health insurance contributions for basic welfare recipients must be sufficiently covered by the federal government," states a nine-page position paper from the NRW Ministry of Health to the Federal Ministry of Health, as reported by the Rheinische Post in its Monday edition. "It is difficult to justify to taxpayers that they are effectively co-financing core state responsibilities through their GKV contributions. Against this backdrop, the proposed austerity measures are seen as unbalanced, inadequate, and therefore highly problematic."

Laumann is also pushing to extend the planned phase-out of free co-insurance for spouses to include civil servants. "It must be ensured that no measures are implemented in the statutory health insurance system that cannot be mirrored in the civil service supplementary assistance system," the paper states regarding the "contribution requirement for spouses." The ministry suggests exploring ways to better align the two systems. Under Warken's proposal, dependents of insured individuals who are neither employed nor caring for children or relatives would be required to pay 3.5 percent of their partner's income for coverage.

The NRW minister further criticizes the reduction in sick pay. "Cutting regular sick pay by five percentage points is viewed as highly problematic," the document continues. "Insured individuals who transition from wage continuation to sick pay typically suffer from serious illnesses." Laumann argues that the federal government should first assess the impact of the new partial work incapacity regulations before implementing further cuts.