Possible changes to health insurance companies are imminent.

Germany has long been considered a promised land for highly qualified professionals , not least because of its first-class social welfare system. But anyone following the news these days senses a growing sense of unease among those we are trying so hard to attract to our economy. While politicians are desperately searching for ways to accelerate the digitalization of immigration administration and lower the barriers to labor migration , a new obstacle is looming elsewhere: the cost of living and healthcare in Germany is rising dramatically. Those who come to Germany with a work visa carefully calculate their future. But the current austerity package from Health Minister Nina Warken (CDU) could jeopardize this calculation for many talented foreign workers.

Fiscal reality and the pressure for reform

The figures presented by the Ministry of Health are sobering. Health insurance expenditures exploded last year by almost eight percent to €352 billion. For the current year, an even further increase to €370 billion is expected. As a law firm specializing in visa law, we are observing this development with concern, as social security, as stipulated in Section 2 Paragraph 3 of the German Residence Act (AufenthG), is a crucial component for a secure livelihood. The Minister's goal is clearly defined: €20 billion in relief for statutory health insurance. However, the way in which these savings are to be achieved will directly impact the finances of those insured. The era of stable contributions and low co-payments appears to be definitively over.

Higher hurdles for basic medical care

For well-educated immigrants, who often have above-average incomes, the planned increases in co-payments for medications are financially manageable, but they send the wrong message. If the minimum co-payment rises from €5 to €7.50 and the maximum to €15, this represents a significant additional burden . However, we are particularly critical of the elimination of preventative services such as skin cancer screenings for those without symptoms. Prevention is the foundation of a modern healthcare system , and skilled workers , especially those from countries with different climates, rely on such preventative examinations. The fact that these are now to be cut is short-sighted from a health policy perspective and represents penny-wise and pound-foolish.

The end of free co-insurance for spouses

Perhaps the most significant change for international families concerns the so-called family insurance under Section 10 of the German Social Code, Book V (SGB V) . Previously, spouses without their own income could be co-insured free of charge – a major competitive advantage for Germany in attracting global talent. The austerity package now stipulates that, starting in 2028, spouses who do not fall under specific exemptions (such as raising children under seven or caring for relatives) will be required to pay their own contribution of 3.5 percent. This "modification" is, in effect, a hidden contribution increase for foreign families , who often rely on one partner initially pursuing a career in Germany while the other is still undergoing the recognition process or learning the language.

Criticism of the burden-sharing arrangement and lack of incentives

We must clearly criticize the fact that the burden-sharing of the Warken package falls on those who significantly support the system through their contributions. While administrative expenses of the health insurance funds are to be limited and advertising budgets halved, the major structural question remains unanswered: Why doesn't the federal government fully assume the costs for recipients of basic income support? This is a political debate being waged at the expense of those who pay into the system. For highly qualified migrants who make a conscious decision for or against Germany, a system in which benefits are cut and new contributions are simultaneously introduced is hardly attractive. Those who want talent cannot simply view the welfare state as a piggy bank.

A look into the future: Taxes on sugar and tobacco?

Whether this package will be sufficient to stabilize the statutory health insurance system in the long term remains questionable. Health Minister Warken has already indicated that she supports a sugar tax as well as higher taxes on alcohol and tobacco. While this would fall under the purview of the Finance Minister, it shows the direction things are headed: Life in Germany is becoming more expensive. For our clients, this means that budget planning for their stay in Germany will become more complex. It remains to be seen whether the Bundestag will pass the law before the summer recess, but the course has been set for a significantly more expensive healthcare system.

Conclusion

Nina Warken's austerity package is a necessary but painful cut. While some efficiency measures at health insurance companies and pharmaceutical manufacturers are welcome, we view the additional burdens on policyholders critically. In particular, the weakening of free co-insurance for spouses diminishes Germany's attractiveness to foreign skilled workers and their families. A modern country of immigration should strengthen social security, not complicate it with bureaucratic additional contributions.

How Visaguard can support you

As a specialized law firm, we keep you informed amidst the maze of legal changes. We support companies and skilled workers in ensuring they meet the requirements for a residence permit, even under altered financial circumstances. Whether it's verifying sufficient means of subsistence or advising on social security agreements – we at Visaguard are your partner for legally compliant migration to Germany. Together, we find solutions to ensure your start or continued stay in Germany is a success, despite rising costs.

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