1. Overview
The federal government is considering ending the contribution-free health and long-term care insurance for spouses without their own income. The change is aimed at reducing a large deficit in statutory health insurance funds and creating incentives for paid work. Under the proposal, a flat minimum contribution of about €225 per month (roughly €200 for health insurance and €25 for long-term care insurance) could become due for affected spouses.
At the same time, exemptions are being discussed for certain groups: parents with very young children and people who provide significant care for relatives. Experts appointed by the health ministry have proposed ways to protect care work and focus co-insurance on children, but final political decisions have not yet been taken.
2. What exactly is being proposed?
The central idea is to abolish the practice that allows a spouse without income to be covered free of charge through the employed partner’s statutory health insurance. Instead, the spouse would either pay a flat-rate minimum monthly contribution or be required to take out their own insurance coverage.
Minimum flat contribution
Under current drafts, the flat minimum contribution is around €225 per month. This consists of about €200 for statutory health insurance and €25 for long-term care insurance. The fee aims to shore up public health finances while keeping the administrative burden low.
Planned exemptions
Lawmakers are considering targeted exemptions to soften the impact on vulnerable groups. The main exemption ideas include:
- Parents with children under six years would remain exempt to support early child care and parental leave.
- Family members who provide substantial caring duties for relatives would be protected to avoid penalizing unpaid care work.
3. Who would be affected?
Roughly 2.5 million people who are currently co-insured without their own contribution could face new costs. Many live in single-earner households where one partner stays at home to raise children or care for relatives. For those affected, the change could mean additional annual costs of about €2,700.
Low-income families, single-earner households, and people who cannot work full time because of childcare shortages or care duties are among the most vulnerable. The policy aims to remove incentives for remaining uninsured or not seeking paid work, but it also risks increasing financial pressure on these households.
4. Political reactions and debate
The proposal has triggered heated debate across the political spectrum. Supporters argue it closes a financing gap and encourages labor market participation, while opponents warn it would hit families and weaken social cohesion.
Support and criticism
Some economists welcome the measure as overdue and say it would correct behavioral distortions. Other voices from social associations and environmental parties argue it would disproportionately burden single-earner families and those already struggling financially.
Key political statements
A leading opposition figure stressed that the question of contribution-free co-insurance matters to many citizens and urged that situations like missing childcare places or care responsibilities, which make paid work difficult, must be taken into account. Another party representative described reports of a final decision as plainly wrong and called for carefully balanced reforms.
A conservative leader has firmly rejected the idea of abolishing free spousal co-insurance, calling such a move the wrong signal to people and saying it would not be an option for his party.
5. Alternatives and expert suggestions
Experts and analysts have proposed a range of alternatives intended to be fairer to low-income families or to better protect care work. These alternatives include contribution splitting, targeted subsidies, or limiting free co-insurance to cover only children.
- Contribution splitting: dividing contributions between spouses in a way that lowers the burden on low earners.
- Targeted exemptions or income thresholds: keeping co-insurance for households under a certain income level.
- Protection for carers: explicit safeguards for people with documented care responsibilities.
Social organizations argue that deeper structural reforms in health and social systems would be preferable to short-term revenue increases that could harm vulnerable families.
6. Public opinion and social impact
Public surveys show a majority opposed to eliminating contribution-free spousal co-insurance, reflecting concerns about higher household costs and fairness. Critics warn of reduced social cohesion if many families face sudden new expenses.
- Short-term: higher costs for affected households, potential need for private budgeting or benefit claims.
- Medium-term: possible increase in job-seeking among some spouses, but only where childcare and care infrastructure allow.
- Long-term: impact on health-system financing and potential reductions in the insurance deficit if implemented as planned.
Potential behavioral effects
Proponents say the reform could increase labor supply by removing incentives to remain out of paid work. Opponents respond that without enough childcare or adequate support for carers, many people could not realistically enter the workforce even if co-insurance were abolished.
7. Practical advice for affected households
If you or your household could be affected, consider these practical steps now to prepare:
- Budget for potential new monthly costs and calculate yearly impact.
- Check with your statutory health insurer for official notifications and details about exemptions or transitional rules.
- Explore whether part-time employment, social benefits, or contribution-splitting proposals could reduce your net burden.
- If you provide care, collect documentation to demonstrate care duties that may qualify you for protection.
- Seek advice from a social counselor or consumer advice service to understand options and entitlements.
8. Timeline and next steps
An expert commission has already presented proposals that include limiting co-insurance to children and protecting care work. Final political decisions will depend on the commission’s full report and subsequent negotiations within the governing coalition and with opposition parties. Any legislative change will then go through the normal parliamentary process and may be amended before becoming law.
For now, households should stay informed through official announcements and prepare for possible changes, while policymakers weigh trade-offs between fiscal consolidation, work incentives, and protecting families and carers.
