Those with statutory health insurance must expect higher contributions next year. Because the GKV estimators have recommended a significant increase in their forecast. Why is that? And what does that mean for insured people?

The contributions of employees and employers to statutory health insurance could increase significantly in 2025. The statutory health insurance (GKV) estimators assume a financing gap of 13.8 billion euros for 2025 and therefore recommends increasing the average additional contribution by 0.8 percentage points to 2.5 percent.

According to GKV information, the Schatzkreis’ forecast is a theoretical size that results from the ratio of the health insurance companies’ current income and expenditure as a whole. The health insurance companies’ expenses in 2025 are estimated at 341.4 billion euros.

What does this mean for insured people?

According to the GKV, there are 75 million legally insured people in Germany. However, precise information about the actual amount of costs for the individual cannot yet be provided. The Ministry of Health will announce an average additional contribution for the coming year based on the estimate by November 1st. The health insurance companies then determine the exact amount for themselves.

According to a constantly updated GKV list, the additional contribution is currently between 0.7 and 3.28 percent. Below is a fund that does not charge any additional contributions. The average additional contribution rate charged by health insurance companies was 1.78 percent in August, as the Federal Ministry of Health announced.

Mathematically, an increase of 0.8 percentage points for a gross income of 3,000 euros per month would mean twelve euros less net – the employer pays the other twelve. If a fund increases the additional contribution rate, members have a special right of termination.

Why are contributions increasing?

According to the Ministry of Health, health insurance expenditure in the first half of the year was 161.3 billion euros – an increase of 7.3 percent compared to the same period last year. Expenditure on hospital treatment increased by 3.6 billion euros in the first six months and is therefore a significant driver of the high spending dynamics, the ministry said in September.

Increasing case numbers and rising nursing staff costs are among the reasons given. In addition, spending on medicines increased by ten percent (2.5 billion euros) in the first half of the year.

The health insurance companies had already pointed out at the beginning of September that their expenses had increased even more sharply in the first half of the year than in the first quarter. The deficit has grown to more than two billion euros and will reach up to 4.5 billion euros for the year as a whole. For adequate financing, the additional contribution for the current year should not have been an estimated 1.7 percent last fall, but rather two percent, according to the National Association of Statutory Health Insurance Funds. He also announced that he expected an additional contribution rate of at least 2.3 percent for 2025.

Why is there the additional contribution?

The additional contribution was introduced in 2015 by the then ruling grand coalition. Health insurance companies should be able to compensate for financial bottlenecks. Until 2018, it was borne solely by health insurance members. Since January 1, 2019, the additional contribution has been paid equally by employees and employers.

With the introduction of the additional contribution, the general contribution rate was reduced to 14.6 percent. Previously it was 15.5 percent.

What role does it play? Federal government?

Health Minister Lauterbach had already expected rising contributions at the end of August. At the end of August he said in an interview that it was now “the phase in which we have to take money into our hands, including that of the contributors”. He justified this with the lack of reforms in the past, for example for hospitals. This is to be decided in the Bundestag on Thursday.

But critics also see the current government as responsible. Doris Pfeiffer, chairwoman of the National Association of Statutory Health Insurance Funds, criticized the fact that “health policy is passively watching the ever faster spiral of contributions.” The federal government must live up to “its responsibility for tasks for society as a whole that have previously been borne by the health insurance companies”.

In the coalition agreement, the traffic light government agreed to finance higher contributions for those receiving unemployment benefit II from tax revenue.

Carola Reimann, Chairwoman of the AOK Federal Association, said: “It is a social policy scandal that the closure of the gap is being foisted solely on those paying contributions and at the same time the federal government’s financing responsibility is being ignored when it comes to refinancing the health costs of citizens’ benefit recipients.” So would employers and contributors forced to finance compliance with the debt brake.

What does this mean for social security contributions overall?

The sum of all social insurance contribution rates will approach a 20-year high in 2025. Together with pension, nursing and unemployment insurance contributions, social security contributions would then rise from the current 40.9 percent to 41.7 percent. Childless contributors report an additional 0.6 percentage points in nursing care insurance. The last time the contribution rates were even higher was in 2006 at 41.9 percent. The record value was reached in 2003 with 42.0 percent.

The level of social security contributions is a recurring issue in Germany because, as additional wage costs, they make work more expensive and reduce net wages. The traffic light coalition is currently arguing about this over several projects. The FDP parliamentary group in the Bundestag is slowing down the pension package agreed in the federal government because the associated guarantee for the pension level means that the contribution rate continues to rise.

In addition, Finance Minister and FDP leader Christian Lindner does not allow a regulation from Labor Minister Hubertus Heil (SPD) to be passed in the cabinet, with which social contributions for high earners are adjusted annually to the general wage development and thus increased.