Goodbye Free Insurance? Millions of Germans Could Pay Big!
The German government under Chancellor Friedrich Merz is considering a major reform of the statutory health insurance system (GKV) that could eliminate the free co-insurance for spouses without their own income. Currently, these spouses are covered automatically under family insurance, a cornerstone of the solidarity-based system, but the proposed change would require them to pay a minimum monthly contribution of around €225.
The measure is being discussed as a way to relieve financial pressure on health insurance funds, which face rising expenditures and limited revenues. Officials argue that requiring contributions from spouses would align the system more closely with individual contributions rather than automatically factoring in household composition. Proponents say it could save billions of euros and encourage greater participation in the labor market.
Households where one partner has no or low income, such as families where one parent stays home for childcare or eldercare, would be most affected. For these families, the reform could increase costs by roughly €2,700 per year. Estimates suggest that approximately 2.46 million households could face these additional financial burdens.
The plan has drawn strong criticism from social organizations and trade unions, which argue that free co-insurance is vital for supporting unpaid caregivers and low-income families. CSU leader Markus Söder has also publicly opposed the measure, warning that it would place undue strain on families. Critics see it as undermining the solidarity principle of the German health system.
Meanwhile, some economists and business voices support the reform for labor market reasons. Studies indicate that abolishing free spouse co-insurance could theoretically boost employment by 150,000 full-time positions. However, experts caution that while it may incentivize work, it will not fully resolve the structural financial challenges facing Germany’s health insurance system.