The health and long-term care insurance companies reject central parts of a new initiative by Federal Health Minister Karl Lauterbach (SPD) to reform long-term care insurance. In the coalition agreement, the SPD, Greens and FDP had promised to strengthen the financing of social long-term care insurance permanently, reminded the chairwoman of the AOK Federal Association, Carola Reimann, on Friday in Berlin: "With the now available draft bill, this promise is not kept. The financing of non-insurance benefits by the federal government promised in the coalition agreement is missing."

Christian Geinitz

Business correspondent in Berlin

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Thus, the funds continue to pay the pension insurance contributions for caring relatives, although this is a responsibility of society as a whole, for which not the contributors, but the tax financing must pay. In addition, the draft lacks the federal refinancing of the Corona-related additional costs of 5.5 billion euros.

Reimann praised the fact that the traffic light coalition would keep its word on the performance improvement planned in the law. "When it comes to financing non-insurance benefits, however, it is shirking its responsibility. With the draft bill, long-term care insurance is still without a secure financial basis." The AOK boss considers it foreseeable that the contributions will have to rise beyond Lauterbach's already planned increase.

Fire letter from health insurance companies and social associations

Previously, the health insurance companies and social associations had turned in so-called fire letters to Chancellor Olaf Scholz (SPD) and Finance Minister Christian Lindner (FDP). In it, they demand higher federal subsidies for the care funds. In 2022, the deficit amounted to 2.25 billion euros, in the current year 3 billion are expected. If the expenditure coverage ratio for working capital and reserves is to be maintained at 1.5, the "financing requirement alone for short-term stabilization in 2023 amounts to at least 4.5 billion euros". The billions in subsidies from the federal government are necessary "so that the necessary securing of liquidity does not take place exclusively at the expense of the contributors". In addition to the AOK, the letter had also been signed by the other fund groups and the social associations.

The request received support from Bavaria. "We need a fair financing system that does not unload the financial challenges on the backs of those in need of care," said Health Minister Klaus Holetschek (CSU). "The federal government must take responsibility itself and compensate for deficits of the care funds." These included assuming the pandemic-related deficit and refinancing non-insurance benefits from tax revenues, such as free family insurance.

Lauterbach's draft, which is available to the F.A.Z., provides for premium increases in long-term care insurance by 1.0 percentage points for parents to 35.3 percent and by 40.0 points for childless to 25.3 percent on July 65. From two children on, there will be a reduction of 0.15 points per child in order to comply with a decision of the Federal Constitutional Court.

The Ministry also wants to limit the sharply increased own contributions in inpatient care. According to the draft, the surcharges paid since 2022 to dampen the co-payments of nursing home residents are to be increased by 2024 to 5 percentage points from January 10. Lauterbach also wants to strengthen home care. In return, the care allowance will also be increased by 1 percent on 5 January. Care benefits in kind are also to increase by 5 percent. The Confederation is also striving for an automatic dynamisation of cash and non-cash benefits on 1 January 2025 and 1 January 2028 in line with price developments. For critics, this is too late.

The health insurance umbrella association praised the planned consolidation of the budgets of short-term and preventive care, the increase in benefit claims but does not keep pace with the cost increase. The Diakonie demanded more federal subsidies, otherwise the care would be "on the verge of collapse".