Care is becoming more expensive: Government plans cuts and higher contributions

The federal government is working on a reform of the social long-term care insurance, which tackles two levers at once: benefit expenditures are to be limited, and revenues increased through higher contributions. At its core, the aim is to reduce the foreseeable funding gaps of the care funds without driving the system into a contribution spiral in the short term.

Planned interventions in the draft law

According to information from government circles, Federal Health Minister Nina Warken (CDU) is preparing a draft law that bundles several interventions: relief supplements for nursing home costs are to take effect later, access to a care level could become stricter, childless people are to pay higher contributions, and the contribution assessment ceiling is to rise. The package would thus not only shift the level of benefits, but also change the group of those entitled to claim and the distribution of the financing burden.

Warken relies on later subsidies and stricter access

A central point concerns the supplements that are intended to relieve care recipients in nursing homes depending on the length of stay. According to the plans, these supplements would each take effect six months later than before. For those affected, this means: personal contributions in the home could remain high for longer before the intended relief becomes noticeable.

At the same time, the draft provides for raising the requirements for classification into a care level. If implemented in this way, benefits from the care insurance would apply later or not at all for some applicants. Politically, this is a sensitive lever: it does not work through individual euro amounts, but through who is able to access the benefit system at all.

Higher contributions: Childless people and higher incomes more in focus

On the revenue side, the ministry is relying on higher contributions. Higher care contributions are planned for childless people as well as an increase in the income threshold up to which contributions are due (contribution assessment ceiling). If this ceiling rises, contributions are levied on a larger portion of income – this increases the revenues of the care funds, but mainly affects insured persons with higher wages and salaries.

For 2026, the contribution assessment ceiling in health and long-term care insurance is 69,750 euros per year (5,812.50 euros per month). The general contribution rate in social long-term care insurance is 3.6 percent; for childless people, a surcharge of 0.6 percentage points is added (Bundestag, documentation from 04.06.2026). According to the current status, the reform would address these parameters: those without children would be more heavily charged, and those earning above the previous assessment ceiling would also pay additional contributions if it is raised.

Why the care funds are under pressure – and why the government is acting now

The reform plans have arisen against the background of a tense financial projection. For 2025, a surplus of around 0.5 billion euros is expected; for 2026 and 2027, however, the projection assumes a deficit in each case, the exact extent of which is considered difficult to predict (Bundestag, hib-short report from 14.01.2025). The political logic is clear: if expenditures continue to rise and at the same time fewer contributors face more people in need of care, the pressure increases to either limit benefits or raise contributions – or to combine both.

It is striking that Warken's approach is not only being discussed in terms of cuts and contribution rates. In a programmatic line, the ministry also emphasizes involving care workers more and expanding competencies – for example, through less bureaucracy and clearer, nationwide standardized training paths, so that care provision in everyday life can become more efficient (Federal Ministry of Health, 11.09.2025). For the financial issue of care insurance, this is not a quick fix, but an indication that the government does not treat the crisis solely as a calculation problem, but also as a structural problem in the system.

What remains open

Whether and in what form the package of measures will come is still open in the ongoing legislative process. However, it is clear: the concept relies on a noticeable redistribution of burdens. Care recipients in nursing homes would have to wait longer for relief supplements, access to benefits could become more restrictive – while childless people and those with higher contributory incomes would pay more. This makes the care reform a distribution decision that will be evaluated not only in terms of fiscal policy, but also in terms of social policy.