The Federal Government’s care structure commission officially began its work on Tuesday – almost two weeks after its appointment by the Cabinet. The 13-member expert body is to draw up proposals for a long-term reform of care so that care remains affordable in future without sharply rising contributions, as tagesschau.de reports.
The chair is taken by the former Secretary General of the German Caritas Association, Prof. Dr. Georg Cremer, and Prof. Gabriele Kuhn-Zuber, President of the Catholic University of Applied Sciences for Social Work Berlin. The body also includes Prof. Dr. Christine Arentz, Michaela Evans-Borchers, Jürgen Graalmann, Prof. Dr. Martina Hasseler, Prof. Dr. Dörte Heger, Prof. Dr. Stefan Huster, Prof. Dr. Thorsten Kingreen, Hans-Dieter Nolting, Prof. Dr. Heinz Rothgang, Prof. Dr. Gregor Thüsing and Rita Zöllner.
The timetable is tight: the commission is to present its proposals by the end of January 2027 at the latest. The black-red coalition wants to launch the reform based on them as quickly as possible so that it can enter into force on 1 July 2027.
A gap of around eight billion euros
The pressure to act is great. At the end of September the Federal Cabinet had agreed on the so-called Care Reorganisation Act. It is initially intended to secure the financing of care insurance in the short term: the measures envisaged are meant to close the funding gap of around eight billion euros expected next year.
The commission is also to draw up a “major structural reform” in order to “ensure good care provision and keep the contribution rate to social care insurance stable into the years after 2030”, as Federal Health Minister Carsten Linnemann (CDU) put it. At the appointment of the body in mid-October, Linnemann said, according to pharmazeutische-zeitung.de and Tagesspiegel: “Our mandate as a coalition is clear: care must be affordable and targeted, care must arrive where it is needed.” It was particularly important to him to focus on those “who take responsibility for relatives at home every day”.
In substance, it is not only about the level of contributions but also about making benefits more precisely targeted. The body is to examine how spending by social care insurance and private compulsory care insurance develops and which benefits are rising particularly sharply. Prevention and early rehabilitation as well as home care are also to be strengthened – including the compatibility of care and work and the particular needs of young people in need of care and of people with disabilities.
Dispute over the care cap
A central point of contention remains the capping of co-payments. Despite the joint decision with the Union, the SPD is pressing for improvements and a social balance between statutory and private care insurance. It had proposed a so-called care cap, which the CDU however blocked. The commission is now to examine whether and how co-payments can be capped; models for compensation mechanisms within and outside the two insurance systems are also to be examined.
Criticism came from the opposition. “I expect bold proposals from the commission, not lists of cuts. That includes, for example, effectively capping co-payments in care,” said the care policy spokesperson of the Greens parliamentary group in the Bundestag, Simone Fischer, according to pharmazeutische-zeitung.de. The Left party group leader Sören Pellmann called it there a “damning verdict” that the care cap does not appear specifically in the commission’s mandate.
DAK chief executive Andreas Storm had already raised doubts about the tight timetable. “I still lack the imagination as to how a comprehensive and viable reform concept is to be presented in the short time until the end of January,” he told the Tagesspiegel in mid-October. Linnemann had declared in September that the care system was currently not fit for the future and would collapse in the 2030s without far-reaching reform.
Criticism from the care sector
After the announcement of the appointments, criticism had been voiced by several care associations. In their view, active care is not sufficiently represented on the body, as ARD correspondent Katrin Aue reports according to tagesschau.de. The Pflegebündnis Mittelbaden had accordingly denounced that the commission consisted of economists and lawyers. The German Nursing Council “as the professional-political representation of care” had not even been asked to participate in the commission.
A first aid package has already been decided, which received the green light in the Cabinet in September. Among other things, it provides for an increase in contribution rates for the childless as of 1 January 2027 by 0.3 percentage points. The government’s care commissioner, Katrin Staffler (CSU), had described the expertise of the commission members as a “chance for real change in care”.
Editor’s note: Whether the commission can keep to the tight timetable and whether the care cap will come in the end is open. What will be decisive is whether the Union and SPD find common ground after the proposals are presented at the end of January 2027 – the dispute over this has so far only been postponed.
