Commission mandate

The federal cabinet set up the care structure commission on Wednesday, 14 October 2026. Its 13 members come from health, legal and economic backgrounds, and the government's paperwork allows the group to add members or bring in further scientific expertise. The chairs are Gabriele Kuhn-Zuber, a Berlin jurist and professor, and Georg Cremer, a former secretary general of the Caritas welfare organisation. The commission is to analyse spending by the statutory long-term care insurance and recommend financing that is sustainable and matches need. It must also look at more efficient care provision and at how prevention and early rehabilitation can be used more widely.

Home care, financing and the co-payment cap

Health Minister Carsten Linnemann (CDU) put strengthening home care at the centre of the mandate, with a focus on relatives who take on care at home every day. He framed the task around cost pressure.

“The costs are getting out of control, and at the same time people too often do not get the care they actually need.”

The commission's remit on the co-payment cap is limited to a review. The cabinet paper says a limit on co-payments for a nursing home stay is only to be examined, a demand that came partly from the SPD. The mandate goes further on financing, covering capital-funded elements and private supplementary cover, moving benefits unrelated to insurance into budget funding, and models for constitutionally compliant social compensation. One option named in the paper is a risk structure adjustment from private to statutory care insurance, a demand the SPD has made.

Timetable and political dispute

The commission must deliver its first proposals by the end of January 2027 at the latest. The CDU, CSU and SPD coalition will then decide which of them to adopt. SPD parliamentary group leader Matthias Miersch said on 13 October that parliamentary deliberations could start in February 2027. The new care law is due to take effect on 1 July 2027.

The setup had been delayed earlier in October because the coalition partners disagreed over the mandate. The SPD wanted caps on rising co-payments, while Union politicians rejected that idea, and a government spokesman cited a remaining need for deliberation. The first relief measures, which the cabinet approved in September after night-long talks in the ministers' round under Chancellor Friedrich Merz (CDU), only ease the acute shortfall in the short term. The care insurance funds say they need billions quickly to stabilise their finances.

Reactions

The ministry says the aim is good care provision and a contribution rate that stays stable into the years after 2030. The chief of the DAK health insurer doubts that a workable reform concept can be presented by the end of January. Katrin Staffler (CSU), the government's care commissioner, praised the participants' expertise as a chance for a real change in care. In remarks to RP Online she argued that the commission must look hard at home care and dissolve the rigid divide between outpatient and inpatient care, which she said leads to inflexible offers and complicated billing.

The Sozialverband Deutschland (SoVD), led by Michaela Engelmeier, warned against cuts in care. She said the commission must not become the next cost-cutting body.

“We do not need new debates about cuts, but viable solutions for solidarity-based financing.”

Engelmeier added that the composition of the panel matters.