German parliament passes health insurance savings package, GPs warn of 'massive cuts' and 'pitch-black' care

The reform passes

Both chambers of Germany's parliament cleared the way for the statutory health insurance savings package on Friday, 10 July 2026. The Bundestag vote saw 318 in favour, 284 against, and four abstentions. The package is designed to relieve the statutory health insurers (GKV) of sharply rising expenditure in 2027 and prevent new contribution increases. Planned measures include spending brakes on medical practices, hospitals, pharmacies, and the pharmaceutical industry, plus higher co-payments for medicines and restrictions on free family co-insurance for spouses.

GP reaction

General practitioners are now warning of severe consequences for patients. Markus Blumenthal-Beier, chairman of the Hausärztinnen- und Hausärzteverband, told Deutschlandfunk on Saturday: "We will now run massive cutting programmes in the practices." He said demographic trends and other planned reforms mean GPs will have to care for more people while costs for staff and rent are surging. Some practices have already frozen all hiring and expansion because of the draft law. Blumenthal-Beier added that enough GPs aged 63 are saying: "If this comes, I've had enough."

We will now run massive cutting programmes in the practices.

Rural care warning

Blumenthal-Beier expressed disappointment not only with the government but also with the majority of federal states that ultimately supported the savings law. He predicted "massive supply problems in sparsely populated regions" and said he had expected the states to fight harder for GP practices. "If this step does not come, then it will truly be pitch-black in care," he said. The association head also argued the burden is not shared fairly: outpatient care and hospitals are disproportionately affected, while the pharmaceutical industry and health insurers are not being cut adequately.

If this step does not come, then it will truly be pitch-black in care.

Municipalities and states object

Local authorities are also protesting. Achim Brötel, president of the Deutscher Landkreistag, told Funke Mediengruppe that hospitals face additional burdens in 2027, even though districts and cities already have to raise billions to save their clinics from insolvency. "Unfortunately, the Bundesrat once again had neither the strength nor the courage to at least safeguard the interests of the states and municipalities in the mediation committee," Brötel said. A flat-rate cap on emergency service reimbursement would cause structural funding gaps and noticeably worsen nationwide care, he added. Hamburg's First Mayor Peter Tschentscher called the package a "failure of the federal government" and said: "We would have liked to correct it."

Unfortunately, the Bundesrat once again had neither the strength nor the courage to at least safeguard the interests of the states and municipalities in the mediation committee.

Minister's defence

Health Minister Nina Warken defended the law in the Bundestag, stating: "Everyone involved in the healthcare system is making a contribution, because everyone also benefits in the long term from sustainable financing." She described the financial situation of the insurers as dramatic, allowing no delay. Without reform, a contribution increase of one percentage point threatened in 2027. The savings target for 2027 was raised four weeks ago to 18.8 billion euros after expenditure grew eight percent in the first quarter of 2026 alone, far faster than expected. The federal government sweetened the deal for the states with 450 million euros for hospitals and 100 million euros for university clinics.

Everyone involved in the healthcare system is making a contribution, because everyone also benefits in the long term from sustainable financing.

What changes for patients

Insured persons face higher co-payments and benefit cuts. Pharmacy co-payments that have stood at 5 to 10 euros for 22 years will rise to 7.50 to 15 euros. Homeopathic treatments will no longer be covered. Fixed subsidies for dental prostheses drop from 60 to 50 percent of costs. Skin cancer screening every two years for asymptomatic adults will be reviewed. The income threshold for contributions will be raised by an additional 300 euros in 2027. Opposition leaders reacted sharply: Greens faction head Britta Hasselmann said the law would bring "hospital insolvencies, overloaded GPs, and betrayed psychotherapists," while Left faction head Heidi Reichinnek told the Bundestag: "You are endangering human lives with this law."

You are endangering human lives with this law.