Germany is exploring new measures to stabilize its statutory health insurance system, which faces rising costs and a projected €14 billion deficit by 2027. An expert commission under Health Minister Nina Warken presented 66 proposals on Monday, March 30th. It would aim to reduce spending pressures and strengthen the system’s financial sustainability.
Key recommendations include increasing excise duties on tobacco and alcoholic spirits and introducing a tiered tax on sugar-sweetened beverages. The additional revenue would be directed to statutory health insurance, with raised tobacco taxes expected to generate €1.2 billion in 2027 and €3.8 billion by 2030.
The commission also recommends ending free health insurance for spouses and civil partners, except when they have children under six, affecting roughly 1.77 million people. Each would be required to pay approximately €240 per month.
Despite these proposals, the package does not include a reduction in value added tax on medicine, which remains at 19%, among the highest in the European Union. Medicines account for €160 million in daily spending, ranking second only to hospital costs.
Germany’s health spending per capita is the highest in the EU, yet some performance and outcome indicators remain at or below the EU average. The Federal Ministry of Health said it would review the proposals and move swiftly toward a legislative plan. Meanwhile, the Health Finance Commission will continue developing medium- and long-term structural reforms, with further recommendations expected by the end of 2026.
Approximately 90% of Germans rely on public health insurance, which guarantees access to healthcare regardless of income.
Earlier this month, Germany’s parliament voted to abolish the controversial Bürgergeld welfare scheme and replace it with a new basic income support system, known as Grundsicherung, in a move the government says will strengthen work incentives and tighten eligibility rules.
