Billions in damage for health insurance companies: Federal government is planning decisive reforms!

Billions in damage for health insurance companies: Federal government is planning decisive reforms!

The financial burden on health insurance companies caused by recipients of citizens' benefit has reached alarming levels in Germany. According to a recent report by the Frankfurter Rundschau These recipients burden the coffers with billions of dollars. The federal government has already made 800 million euros available to cover the deficits that have arisen. Although this is a step in the right direction, further reforms are considered necessary to avoid future increases in contributions.

Health Minister Nina Warken (CDU) has specialized in ensuring the financing of treatment costs for citizens' benefit recipients. The federal government is currently covering the health insurance contributions for this group, but it has been shown that these payments are inadequate. Unemployed people in statutory health insurance only receive a monthly flat rate of 109 euros, which only corresponds to around a third of what they actually need. According to a report by the health research institute IGES, around 311 euros would have to be paid in 2022 in order to cover costs.

Growing deficits and demands for change

The statutory health insurance companies estimate that the deficit will increase to around ten billion euros per year due to the insufficient contributions. Warken is therefore calling for the treatment costs to be fully covered by the federal budget. She receives support from Klaus Holetschek (CSU), who also demands that non-insurance benefits be replaced with tax revenue. Linda Heitmann (Greens), however, criticizes the federal government's insufficient contributions and calls for financial support to be stabilized.

The problem of health insurance companies getting into financial difficulties due to low contributions is not new, but has hardly been addressed so far. Minister Warken plans to reduce the number of citizens' benefit recipients in order to relieve the burden on health insurance companies. The pressure on the health insurance companies is growing, not least because health and nursing care insurance currently costs 657 million euros per month.

Relationship between costs and utilization

Richard Ochmann from IGES points out that the current flat rate of 119.60 euros per citizen's benefit recipient in 2022 is significantly below the required amount. The state covers up to 421.77 euros of the monthly premium for privately insured citizens' benefit recipients. This disparity has far-reaching effects on health insurance companies; it is particularly noteworthy that the number of ALG II recipients who use statutory health insurance benefits has fallen by 15 percent compared to 2016. Nevertheless, the costs for medical care have risen from 2,368 euros per benefit recipient in 2016 to 2,735 euros in 2022.

The total expenditure of the health insurance companies for ALG II recipients and their co-insured relatives fell from 15.486 billion euros in 2016 to 15.127 billion euros in 2022. This is partly attributed to savings in administrative costs. At the same time, special effects such as the pandemic and the influx of younger, healthy refugees from Ukraine have led to lower use of medical services by ALG II recipients.