Karlsruhe rejects emergency motions against health insurance savings law – Bundestag can vote on Friday

Warken rejects criticism

Federal Health Minister Nina Warken (CDU) likewise rejected the opposition's criticism. The amendment motions had been sent to everyone "in such good time that one was able to deal with them," said the CDU politician. Many points had already been discussed with the parliamentary groups in recent weeks, "and we were able to present a well-rounded package." Warken emphasized at the same time that the timetable had to be met because decisions on supplementary contributions and remuneration increases in the statutory health insurance system were due in the autumn.

Janosch Dahmen had announced on Wednesday that he had filed an emergency motion with the Federal Constitutional Court. On Monday evening, members of parliament had been presented with an amendment motion of nearly 300 pages, the Green politician explained. This amounts to "practically a new law" being placed on the table. "With an amendment motion of around 300 pages, practically a new law had been submitted only on Monday. The billion-euro impact could in no way be seriously assessed in such a short time," said Dahmen. He spoke of a "chaotic legislative process" and doubted that "any orderly parliamentary procedure at all" was still possible for this law.

Dahmen refers to Heilmann

Dahmen explicitly pointed to the case of CDU member of parliament Thomas Heilmann from the summer of 2023. Heilmann had likewise seen his rights as a member of parliament violated at the time because there had been a series of short-notice amendments to the Ampel coalition's Heating Law. The Federal Constitutional Court had provisionally halted the vote on the Heating Law at the time in expedited proceedings; a ruling on the merits is still pending and is to be issued on 23 July. "What is right for Mr. Heilmann should also be fair for me as a member of parliament," said Dahmen. He stressed that he was not suing against a political majority and not for the rights of the opposition, "but I am suing for the rights of the parliament to good legislation, good, informed, thorough deliberations."

Shortly after Dahmen, Left-wing member of parliament Ates Gürpinar also announced he would go to Karlsruhe. "Among the changes are motions that shift items in the billions," Gürpinar criticized. This was not about just any law, but about "the most massive cut to healthcare provision in recent decades." The burden on insured persons, patients and employees in the health sector was "drastic." Gürpinar likewise referred to the Heilmann case.

Opposition draws parallels to 2023

The Greens accused the Union of doing now exactly what it had itself objected to in Karlsruhe in 2023. "According to the Greens, the Union is currently doing what it had itself objected to in Karlsruhe in 2023," it was said in the debate. The AfD also criticized the procedure and called for the vote to be postponed. AfD member of parliament Martin Sichert had likewise threatened to go to Karlsruhe and accused the coalition of trying to "surprise the parliament at short notice" with its amendments.

On Wednesday, the Greens and the Left had already attempted in the Bundestag, by means of a motion under the rules of procedure, to remove the final vote on the reform planned for Friday from the agenda. The coalition of Union and SPD rejected the motion with its majority. The SPD likewise rejected the accusations; from its perspective, the points now being criticized had already been deliberated in a specialist hearing two weeks earlier. Members of the Greens, the Left, as well as the Left parliamentary group had argued, in separately filed motions, that the deliberation time had been too short.

SPD remains relaxed

Parliamentary managing director Dirk Wiese (SPD) appeared relaxed. "The overall circumstances are different from the Heilmann decision in 2023," Wiese said. The SPD parliamentary group assumes that the opposition will fail in court. ARD capital correspondent Birthe Sönnichsen said in conversation with MDR AKTUELL that the opposition was referring to the Thomas Heilmann case. Sönnichsen noted that the court had needed several days for an expedited decision in the Heilmann case.

The reform is the central project of Health Minister Warken to stabilize the finances of the statutory health insurance funds from 2027 onwards and to limit rising supplementary contributions. The package envisages burdens for insured persons, medical practices, hospitals and the pharmaceutical industry. For insured persons, higher co-payments and restrictions on the contribution-free co-insurance of spouses are among the possible changes. According to the federal government, the reform affects up to 75 million people with statutory insurance.

Contents and goals of the reform

Warken emphasized that in some places there had still been changes in favor of the insured. The parliamentary groups had jointly discussed many points over recent weeks and been able to present a well-rounded package. The law would in any case only take effect in 2027, regardless of whether it was perhaps passed a few weeks later, Dahmen stressed – and nevertheless demanded more time: "There is therefore enough time to pause and to look at the impact of the draft law together with experts."

Federal Chancellor Friedrich Merz had defended his reform course in a government statement in the morning, before the Karlsruhe decisions. "I keep hearing the accusation that the political center is not delivering and is blocking itself," said Merz. "The center delivers, it works, and above all it fulfills the mandate from our Basic Law." The government would pursue its course, "even if you try with all means to prevent that by tomorrow."

Bundesrat remains a hurdle

Even if the Bundestag approves on Friday, the Bundesrat remains a hurdle. The Länder could convene the mediation committee and delay the process. Some Bundesrat members have already called for the decision on the health insurance savings package to be postponed. The Bundesrat is likewise scheduled to meet on Friday in its last session before the summer break.

Independently of the health reform, the Federal Constitutional Court also gave the green light for a possible decision on the new Building Energy Act, which is intended to revise central elements of the former Ampel coalition's Heating Law. According to this, new gas and oil heating systems should continue to be allowed to be installed if, from 2029 onwards, they increasingly use CO2-neutral fuels. The Left had previously failed in its attempt to provisionally halt the planned passage of the new Heating Law; the Federal Constitutional Court had declared its organ lawsuit against the old Heating Law inadmissible.

Background: Coalition under pressure

In the healthcare sector there have been protests for weeks, and differing opinions are also reported within the coalition. At the beginning of July, the leaders of CDU/CSU and SPD had met for a top-level meeting after a retreat in the coalition committee that had been prepared over several days. The aim of the meeting was to make economic growth in Germany possible again; a 34-point program with tax relief, labor market flexibilization and a tightened certificate-of-illness requirement is pending in the Chancellery. With the Karlsruhe decisions, Vice Chancellor and Finance Minister Lars Klingbeil (SPD) as well as Labor Minister Bärbel Bas (SPD) can now, according to accounts from coalition circles, focus on further legislation.

On 11 July 2025, the failure of an SPD candidate for the Federal Constitutional Court had plunged the coalition into a first serious crisis shortly before the summer break; Union parliamentary group leader Jens Spahn (CDU) had subsequently had to regain lost trust. Ahead of important state elections in eastern Germany, the coalition partners are in some cases well behind in the polls. The issue is also on the political agenda in Zurich: in the city parliament on Wednesday evening, an SP health package with around half a dozen motions was debated; in the end, the SP found a majority for four of six motions, including with the Greens, Mitte/EVP and GLP, without the AL.