Bundestag and Bundesrat Approve Savings Package for Statutory Health Insurance – Sharp Criticism from Doctors, Municipalities and Hamburg

The package provides for spending brakes for practices, hospitals, pharmacies and the pharmaceutical industry – but also, for example, higher co-payments for medications and restrictions on the free co-insurance of spouses. Warken said: "Wir wollen künftig mit dem Geld auskommen, das wir haben, und nur noch das bezahlen, was nutzt." The total expected savings volume of the package has not been specified concretely to date.

Tschentscher Calls the Decision a "Fehlleistung"

Hamburg's First Mayor Peter Tschentscher (SPD) sharply criticised the savings package. "Als „Fehlleistung der Bundesregierung" hat Hamburgs Bürgermeister Peter Tschentscher das vom Bundestag beschlossene Sparpaket für die gesetzliche Krankenversicherung kritisiert. He regretted that Hamburg's motion to convene the mediation committee did not find a majority. "Die hätten wir gern korrigiert", the SPD politician told the Deutsche Presse-Agentur.

Tschentscher accused the federal government of misguided tax and fiscal policy. The reason was a misguided tax and fiscal policy of the black-red federal government, which on the one hand envisaged high levels of new debt without any plan for financing or repaying the loans. On the other hand, it was making itself incapable of acting "mit Steuergeschenken aus der Gießkanne". Because "hohe Milliardenbeträge an Subventionen" were being distributed elsewhere, there was no financial room for manoeuvre.

The SPD politician argued that non-insurance-related benefits such as the free co-insurance of family members could not be paid from tax revenues. "Das sind hohe Milliardenbeträge, die ausschließlich den Versicherten zur Last fallen", he said. "Das werde stattdessen allein den Beitragszahlerinnen und -zahlerinnen aufgebürdet", Tschentscher criticised.

Family Doctors' Association Warns of Supply Bottlenecks

Criticism also came from the family doctors' association as well as from the rural districts and cities, which are groaning under the costs of hospitals and emergency services. The federal chairman Blumenthal-Beier said on Deutschlandfunk that the changes meant a minus for family doctors. "Wir werden jetzt massive Kürzungsprogramme in den Praxen fahren", the chairman of the Hausärztinnen- und Hausärzteverbands, Markus Blumenthal-Beier, said on Deutschlandfunk.

Blumenthal-Beier pointed first to the capping of remuneration. Second, there were significant deductions if doctors took on patients beyond their budget. "Während bei der ambulanten Versorgung deutlich gekürzt werde, würden andere Bereiche wie die Pharmaindustrie weniger belastet", he criticised. Blumenthal-Beier pointed first to the capping of remuneration. The significantly increased costs for rent and staff would not be offset.

The association chief said there were already practices that, on the basis of the draft law alone, had put all hiring and practice expansions on ice. He complained that, due to demographic developments and further planned reforms, family doctors would have to care for more people. At the same time, costs for staff and rent were rising sharply. There were also enough family doctors who, at 63, said: "Wenn das kommt, da habe ich die Schnauze voll."

Blumenthal-Beier criticised that the law was neither fair nor well-crafted. "Die Hausärzte sei sehr enttäuscht von der Bundesregierung und dem Gesundheitsministerium", he said. "Wenn dieser Schritt nicht kommt, dann wird es wirklich zappenduster in der Versorgung", he warned. He forecast "massive Versorgungsprobleme in dünn besiedelten Regionen".

Municipalities and Rural Districts Fear Hospital Insolvencies

The President of the Deutscher Landkreistag, Achim Brötel, told the newspapers of the Funke Mediengruppe that hospitals faced additional burdens in 2027 – while the rural districts and cities in particular already had to provide billions of euros today to keep their hospitals out of insolvency. Brötel also warned that a blanket cap on remuneration in emergency services would lead to structural funding gaps and noticeably worsen nationwide coverage.

Brötel criticised: "Leider hat der Bundesrat wieder einmal keine Kraft und keinen Mut gehabt, um die Interessen der Länder und Kommunen wenigstens noch im Vermittlungsausschuss zu wahren." A motion by Hamburg in the Bundesrat to convene the mediation committee failed to achieve the required majority. The Bundesrat had cleared the way for the savings package passed by the Bundestag.

The federal government made financial concessions to the states: 450 million euros for hospitals and 100 million euros for university hospitals, as Health Minister Warken announced. Andreas Storm, head of the health insurer DAK-Gesundheit, said that the concessions to the states had created a new gap of 550 million euros at the expense of statutory health insurance. "Mit den weitreichendsten Sparmaßnahmen der vergangenen Jahre hat die Bundesregierung endlich eine Trendwende zur finanziellen Konsolidierung in der gesetzlichen Krankenversicherung eingeleitet", Storm emphasised.

Health Insurers See New Financial Gap

Storm also said that contributions would thereby be stabilised, at least temporarily. "Damit stellt die Bundesregierung ihr eigenes Ziel der Beitragsstabilität ab 2027 jetzt noch einmal selbst infrage", he warned. Examples of non-insurance-related benefits that have long been criticised include health insurance contributions for Bürgergeld and basic security recipients.

In the Bundestag, MPs from The Left and the AfD voted unanimously against the savings package. Individual dissenters also voted against it: SPD member Martin Kröber, Greens MP Steffi Lemke and the non-attached Jan-Wenzel Schmidt. CDU MPs from Saxony-Anhalt voted unanimously in favour of the savings package despite warnings from the state.

Psychotherapists Protest Against Fee Cuts

The planned Contribution Stabilisation Act also provides for the abolition of the minimum fee for psychotherapists and a cap on the budget for treatments. The so-called extra-budgetary status for psychotherapy is to be eliminated, as is the so-called appropriateness review for psychotherapeutic services. Tobias Krull, social policy spokesperson of the CDU parliamentary group in the state parliament of Saxony-Anhalt, warned: "Wir befürchten vor allem, dass sich angehende Psychotherapeutinnen und Psychotherapeuten dann gegen eine berufliche Zukunft in der Niederlassung entscheiden oder nur Privatpatienten versorgen. Das könnte zu einer weiteren Verschärfung der Versorgungslage führen."

Lisa Marie Hubbe, state chair of the Deutsche Psychotherapeuten Vereinigung (DptV) in Saxony-Anhalt, said: "Wir können wirtschaftlich nicht mehr planen, weil wir dann keine gesetzliche Grundlage mehr dafür haben, dass wir auch immer unser festes Gehalt haben." Among psychotherapeutic colleagues one was experiencing "eine Ohnmacht, Besorgnis und große Unsicherheiten". Patients currently waited on average six to twelve months for the start of psychotherapy; for children and adolescents, waiting times of up to a year and a half were to be expected.

The child and adolescent psychotherapist Julia Rasp from Halle (Saale), who recently completed her training, said: "Ich dachte eigentlich nach der Ausbildung gibts endlich Sicherheit und darauf hab ich mich auch gefreut. Und jetzt ist es irgendwie erstmal unklar, was in der Zukunft passiert." She did not want to open her own practice under the current conditions. Kristin Ackermann, who has run a psychotherapy practice in Gardelegen (Altmarkkreis Salzwedel) since 2015, said: "Meine Praxis wird damit weiter unter Druck geraten und Druck ist keine gute Vorrausetzung, um zu arbeiten."

Voices from the Field

State parliamentary groups in Saxony-Anhalt from the CDU, SPD, FDP, Greens, The Left, AfD and BSW jointly criticised the planned fee cuts for psychotherapists. Psychotherapists in Saxony-Anhalt had most recently demonstrated against fee cuts of 4.5 percent. Federal Finance Minister Lars Klingbeil, like Tschentscher, belongs to the SPD.

This news was broadcast on 11.07.2026 on the Deutschlandfunk programme. The Bundest