NRW politicians criticize Warken's care reform as a burden package

According to the Federal Ministry of Health, the long-term care insurance faces a deficit of 22.5 billion euros in the next two years. The draft aims to reduce expenditures and increase revenues. Higher burdens are planned for higher earners, childless individuals, and mini-jobbers. At the same time, benefits are to be cut or made more difficult to obtain, among other things, through stricter criteria for recognizing care needs. In addition, care insurance funds will pay lower contributions for family caregivers in the future.

Criticism from Associations and States

Clear criticism of the draft came from federal states, municipalities, and associations. The Paritätischer Gesamtverband sees no solution for the structural problems of long-term care insurance in the plans. Chief Executive Joachim Rock said: "Instead of a fundamental reform of care, the federal government is cutting at the expense of care-dependent people and their relatives, as well as care facilities and their employees." Daniela Teichert, Chairwoman of the Board of AOK Nordost, criticized that the relief amount for care-dependent individuals with care level 1 is to be reduced. She also expressed concern about the planned postponement of benefit allowances for people in inpatient facilities.

Opposition is also coming from within the coalition parties. The SPD parliamentary group's spokesperson for health policy, Nicole Knudsen, and the SPD parliamentary group's spokesperson for care policy, Thorsten Klute, sharply criticized the plans. Klute told WDR that he saw the federal government endangered by the reform plans. He warned that the number of care-dependent people would increase: "The number of care-dependent people will increase." It is "completely utopian to believe that we could fully cover this with professional caregivers."

SPD and CSU Sharply Criticize

Klute particularly criticized the planned cuts to pension points for family caregivers: "To punish them now in this situation with deductions in pension points is simply socially unacceptable." He called for more support for this group: "This is not justifiable at this time. We need more support for family caregivers, not less." Klute also fears that municipalities will have to compensate for the cuts in care subsidies.

Mecklenburg-Western Pomerania's Health Minister Stefanie Drese (SPD) criticized the plans on Thursday in the state parliament. She stated that it was not a real care reform, but an attempt to close financing gaps without fundamentally restructuring care. Minister President Manuela Schwesig (SPD) also spoke out against the draft. She said the proposals would place a greater burden on care-dependent individuals and their families and worsen conditions for caregivers. She called Warken's plans "not a reform, but a burden package" to Politico.

"A care reform that leads to care becoming unaffordable is not a reform," Schwesig said. A nursing home place in Mecklenburg-Western Pomerania costs an average of almost 3,000 euros per month, which is 345 euros below the national average. Schwesig criticized that the reform would further drive up these costs and exacerbate the situation for those affected and their relatives.

Laumann Defends Parts of the Reform

Criticism also came from the CSU. Klaus Holetschek, former Bavarian Health Minister and now CSU parliamentary group leader in the Bavarian state parliament, told the Augsburger Allgemeine: "If relief measures take effect later, the additional costs will ultimately fall on the municipalities and the care-dependent." He called the plans "not a real reform, but a transfer station towards social assistance."

The Union expressed support for Warken. He stated that there could be no "business as usual" with endlessly rising contributions. North Rhine-Westphalia's Health Minister Karl-Josef Laumann (CDU) described the plans as "a pragmatic and sensible approach to keeping contributions to long-term care insurance reasonably stable." At the same time, he expressed clear rejection of the planned suspension of the fair wage regulation: "What I see critically is the planned suspension of the fair wage regulation." He announced that he would examine these regulations very closely again.

Laumann referred to his role in introducing the fair wage regulation: "I strongly supported the introduction of the regulation at the time, and it also led to a significant increase in pay in the care sector." This positioned Laumann as a defender of higher wages in care, while he fundamentally supported the overall reform course. This indicates a balancing act between cost discipline and wage levels in the Union's internal debate.

The Bremen health economist and care researcher Heinz Rothgang also expressed sharp criticism of the austerity measures to the Evangelischer Pressedienst. Rothgang said that the revenues from higher contributions for childless individuals were likely overestimated by double. He also predicted: "Furthermore, the number of applications for a care level or an upgrade is likely to explode before the reform takes effect." The draft would not achieve the savings target announced by Warken.

Care Researcher Rothgang Doubts Success of Savings

Rothgang further criticized the planned capping of salaries as a "bad signal" for attracting new caregivers. He advocated for financing pension contributions for family caregivers from tax revenue rather than from long-term care insurance. At the same time, he expressed positive surprise at elements of the reform, such as mandatory professional care support and the expansion of digital services.

Rothgang pointed out that long-term care insurance was originally designed to support family caregivers, who were supposed to receive the same pension contributions as an average employee in Germany despite significantly longer working hours. He said: "This means that even if I fully care for someone with care level 5 myself, I receive contributions that are only 70 percent of what an average earner pays."

According to estimates by the Federal Statistical Office, around seven million people in Germany who care for a close relative are affected. In Central Germany, according to the Federal Statistical Office, this number is about 500,000 people. Almost three-quarters of family caregivers in Germany are women.

Affected Individuals Criticize Lack of Appreciation

Cornelia Schneider, chairwoman of the association "Pflegende Angehörige" (Family Caregivers) with 565 members, personally cared for her severely ill husband for 32 years and her mother for four years. She said: "It simply appalls me." Schneider demands that pension contributions be removed from long-term care insurance. She perceives the federal government's proposals to reduce pension contributions for family caregivers as a dramatic breach of trust.

Schneider reported that she had participated in a workshop with the Family Ministry at the beginning of the year, where numerous care organizations were represented. She had only a few minutes to present the most important concerns of her 565 members. "I am not sure to what extent we family caregivers have any value at all," she said.

Mixed Signals from Substitute Funds and AOK

The Association of Substitute Funds (vdek) recognizes partially sensible approaches in the reform, such as the stronger focus on prevention, rehabilitation, and digitalization, and welcomes the fact that care benefits are to be regularly adjusted from 2028. At the same time, the association accuses the federal government of not fulfilling its financial responsibility sufficiently. The care insurance funds still have more than five billion euros owed to them by the state from the COVID-19 pandemic, with no repayment planned.

AOK Nordost, on the other hand, considers the reforms necessary to stabilize the system in the long term. This positions Germany's largest health insurance company fundamentally behind the austerity course. The reform debate thus remains controversial within the landscape of care and health insurance funds, as the planned cuts in care benefits and pension points are, from the perspective of affected associations, hardly compatible with the goal of better care.

The draft also provides for restrictions on the co-insurance of spouses without contributions and a tightening of the prerequisites for classification into a care level. The federal government intends to generate additional revenue and reduce expenditures through these measures in order to secure the financing of long-term care insurance in the coming years.