Health insurance companies: Court of Auditors: Additional contributions could rise sharply

The health insurers in Germany are noticeably increasing additional contributions. After a record growth in the expenditure last year, the income from the health insurance companies would continue to remain under the expenditure in the future, the Federal Audit Office predicts in a new report on the Bundestag’s budget committee. The annual billion -off deficit would result in “an increase in the average additional contribution rate of 0.3 contribution rate points per year”.

The financial inspectors refer to a forecast of the Federal Ministry of Health, which in a middle scenario expects an increase to 4.05 percent by 2029. The 35-page report from which the news portal “Politico” quoted is available to the German Press Agency in Berlin.

The Federal Government accuses the Court of Auditors. “The federal government wants to set up an expert commission and pushes necessary steps to the long bank,” criticizes the authority. Federal Minister of Health Nina Warken (CDU) told the “Frankfurter Allgemeine Zeitung” in May that “initial countermeasures” against the increase in contributions were necessary before the results of the planned reform committee.

The Court of Auditors points out that the average additional contribution rate has increased by 0.9 percent by 1.6 contributions since 2015. “The financial situation of the SHI is increasingly putting up contributors as well as employers.” The overall social security contribution – i.e. the contributions of the other social security – rose by almost one and a half percentage points to 42.3 percent in 2025.

Stronger than in any other year in 30 years

With health insurance alone, the gap between income and expenses grow by 6 to 8 billion euros annually. Currently, expenses compared to the previous year with 8.2 percent “has increased more than in any other year of the past three decades”.

At the beginning of 2025, the additional contributions, which the health insurers set for their insured persons, rose to an average of 2.9 percent. That was more than the expected increase by 0.8 points to an official orientation value of 2.5 percent. The overall contribution also includes the general set of 14.6 percent.

750 euros more for the health insurance company per year

The green household and health politician Paula Piechotta said: “The Court of Auditors is tearing the plan of Warken in the air to wait longer with the reforms of health and long-term care insurance and instead decide on points that even increase the financial problems.” In view of the rushing deficits, a contribution rate of up to 18.65 percent can be expected in the SHI alone. “With a monthly salary of 4,000 euros, these are almost 750 euros more per year compared to health insurance.”

Piechotta painted a dark picture: “But the truth also includes: This coalition does not have the strength or unity to manage a real reform.”

Health insurers call for expenditure moratorium

The GKV top association called for an expenditure moratorium – “so that remuneration, budgets and fees are not allowed to increase more than the income,” as association spokesman Florian Lanz explained.

“The financial situation of statutory health insurance is terrifyingly bad,” said Lanz. “This year we experience increases in contributions to an extent that has not been known so far, but instead of continuous political measures, the future increase in contributions should be mitigated by a loan, that is, through new debts.” That is not enough. Structural reforms are necessary.

Federal Audit Office Warken on GKV financial situation