Now the government is pushing high earners back into the public health insurance system.

2026-07-04

Germany's government is planning a major reform of the public health insurance system that could require more high-income earners to remain in or return to the **Gesetzliche Krankenversicherung (GKV)**, the country's statutory public health insurance system. The proposal aims to strengthen the financial stability of public health insurers.

The reform would raise the income threshold used to calculate health insurance contributions and make it more difficult for higher earners to switch to **Private Krankenversicherung (PKV)**, Germany's private health insurance system. As a result, many employees with high salaries could pay significantly higher contributions while remaining in the public system.

According to the proposal, the government wants higher-income workers to contribute more in order to help close the growing funding gap in the GKV. Officials argue that the public health insurance system is under increasing financial pressure due to rising healthcare costs and demographic changes, making additional funding necessary to maintain stable services.

The planned changes have triggered criticism from business groups and private health insurance representatives, who argue that limiting access to the private insurance market could reduce consumer choice and place an unfair financial burden on high earners. Supporters of the reform, however, say those with higher incomes should contribute more to preserve the solidarity-based healthcare system.

The proposal is still moving through the legislative process and has not yet become law. If approved, the changes would represent one of the most significant reforms to Germany's health insurance system in recent years, affecting thousands of high-income employees and potentially reshaping the balance between public and private health insurance.