States demand expansion of specialist medical care and receive no response from the federal government

According to the states' calculations, the co-financing of hospitals by the federal government and social insurance fell from 59.7 percent of expenditures in 2004 to 56.4 percent in 2024. The federal states see this as a growing imbalance that restricts their room for manoeuvre in hospital financing. They are therefore insisting on a financial readjustment as part of the ongoing reform talks.

Timeline: Reform by 2027

At the same time, the states signalled their willingness to enshrine the reform in law by the end of the year so that implementation can begin in 2027. By the end of June, another meeting of the actors brought together in the so-called Reform Partnership is to take place in Vienna, at which the various positions are to be brought together.

On the federal side, there was initially no substantive response to the states' demands. Federal Chancellor Christian Stocker (ÖVP) announced that a fundamental political agreement should determine "wohin die Reise geht". No concrete commitments on the specialist question or on hospital financing can be derived from this statement.

Response from the Federal Government

Stocker linked the reform discussion to a longer time horizon: he called for a fundamental reorientation of the healthcare system by 2040, for which a directional decision by 2028 would be necessary. This places the current agreement in a broader strategic context that goes beyond the current financing issues.

Health Minister Korinna Schumann (SPÖ) reacted cautiously to the states' initiative. In a written statement, she declared: "Die Einigung der neun Bundesländer auf eine gemeinsame Reformposition ist ein starkes Signal und ein wichtiger Beitrag für die laufenden Reformgespräche". She did not comment on the states' specific demands.

Outlook for the June Summit

It therefore remains unclear how the federal government views the states' central concerns, in particular the increase in federal funds for hospitals and the redesign of the specialist sector. Observers interpret the federal government's silence as tactical waiting ahead of the next reform summit in Vienna.

The states have repeatedly emphasised in the Reform Partnership that they are interested in a joint solution with the federal government. However, if the federal government does not provide substantial answers by the June meeting, the tone in the further negotiations is likely to become sharper.

Parallel to the specialist care discussion, the states point to the investment needs in hospitals, which have grown steadily in recent years. Without a stronger federal contribution, it will be difficult to finance necessary modernisations and the expansion of care capacities.