The health care reform planned by the CDU/CSU-SPD coalition for 2027 has long been a major source of controversy. While the federal government defends the reform as a necessary austerity and stabilization package to avert a looming deficit in the billions by 2030, the planned benefit cuts will result in noticeably higher additional costs for those insured under the statutory health insurance system and for employers.
However, the stricter rules regarding sick leave (certificates of incapacity for work) adopted in recent days have drawn criticism from the opposition, the medical community, labor unions, and social welfare organizations. Employers welcome the measures as a response to high absenteeism rates. Medical associations and unions are sharply critical of them: They fear that general practitioners’ offices will be overburdened by minor cases and unnecessary bureaucracy. Since the bill is still going through the legislative process, the current regulations (sick leave typically starting on the fourth day) remain in effect until the new law is passed.
What exactly is this about?
1. Current Focus: The New Regulations on Sick Leave
As part of its reform package, the federal government plans to tighten the rules regarding sick leave. Sick leave requests made by phone will be eliminated, and a doctor’s note will be required starting on the first day of illness. Many details—such as whether doctor’s notes must be provided on the first day or can be submitted later—are still to be determined. Here is an overview of the most important changes and what will remain the same:
- End of Phone-Based Sick Leave: The rule, in effect since the end of 2023, allowing people to obtain a sick leave note by phone for mild symptoms, is set to be repealed.
- Medical Certificate Starting on Day One: Employees should be required to submit a certificate of incapacity for work (AU) starting on the first day of illness.
- Stricter Penalties: The issuance of false medical certificates by doctors is to be punished more severely under Section 278 of the Criminal Code.
What remains the same (or is still open):
- Online Video Consultations: As things stand now, the option to obtain a sick note via a digital video consultation is expected to remain in place.
- Submission deadline still unclear: A sick note covering the first day does not necessarily mean that the document must be submitted to the Human Resources department on the same day. How this will be regulated by law is still part of the legislative process.
- Possible exceptions: The stricter rule may not apply across the board. Chancellor Merz indicated that companies may establish different rules through individual, company, or collective bargaining agreements.
- No Change to Continued Pay: There is no change to continued pay in the event of illness (typically up to 6 weeks, paid by the employer).
2. Key Points of Criticism of the Health Care Reform
In addition to the recent criticism of the stricter sick leave rules, the healthcare reform is being viewed on several fronts as socially unjust and risky in terms of healthcare provision.
For while there is certainly valid criticism of the stricter rules on sick leave, it is above all the resulting cuts to benefits that will make the statutory health insurance system more expensive for employers and employees. Furthermore, these cuts to benefits carry the risk that the high rates of sickness-related absenteeism—which are also the subject of heated debate—will increase rather than decrease.
Contribution Thresholds and Contributions Are Rising
- The contribution assessment ceiling will be raised by approximately 300 euros in 2027 as a one-time measure. This increase directly affects employers, as they pay the employer’s share of health insurance premiums on a 50-50 basis.
- As the number of higher-earning employees increases, this leads to progressively higher contribution obligations.
- In the future, employers will be required to pay higher contributions for employees in marginal employment. This measure is intended to ensure that people in mini-jobs contribute more to health insurance, which will increase costs for employers.
Copayments and Benefit Reductions
- Dental Prosthetics: Health Insurance Coverage Decreases by 10 Percent
- Prescription drug copayments: rising to as much as 15 euros
- Physical Therapy: Flat copay of 15 EUR per prescription
- Homeopathy Will No Longer Be Covered by Health Insurance
- Free skin cancer screening for people aged 35 and older is under scrutiny
Other Changes to Insurance Benefits
- Family Insurance: Free coverage for spouses and domestic partners will be restricted and will only be available in exceptional cases
- Sick Leave and Recovery: The 6-week limit will apply per year rather than per illness going forward
- Partial sick leave is available to allow employees to work on an hourly basis even while sick.
3. Why the bKV Can More Than Make Up for the GKV's Benefit Cuts!
The bKV is a private supplemental insurance plan for employees funded by the employer. Against the backdrop of the upcoming healthcare reform and benefit cuts, it is one of the most effective components of strategic and operational human resources management.
But what specific added value can supplemental health insurance (bKV) offer in the context of health care reform? To illustrate this, we have compared the major benefit cuts with the benefits of supplemental health insurance.
For more than 20 years, we have been focusing on supplemental health insurance for employees (bKV) and its benefits. Every day, we see the added value that bKV offers to employees and employers. The most important benefits can be summarized as follows:
Take advantage of the healthcare reform now as a way to boost health and motivation in your company!
Almost all stakeholders in the healthcare system view the healthcare reform as nothing more than a cost-cutting measure. The stricter rules on sick leave do not provide lasting relief for health insurance funds or the economy; instead, they shift the burden—in the form of more crowded waiting rooms—onto doctors and increase the pressure on employees and employers.
The bKV not only compensates for benefit cuts, but also demonstrates essential appreciation for all employees. It is therefore not a social benefit or just another cost factor. The bKV is the most effective investment in the health, satisfaction, and productivity of all employees. And thus, it is a key driver of the company’s future success!