Health insurance contributions for citizens' allowance recipients: GKV wants to sue for billions in claims

Berlin. The statutory health insurance (GKV) is taking its case to court, possibly all the way to the Federal Constitutional Court. The trigger is the perceived insufficient contributions that the state pays to health insurance funds to provide care for citizens' benefits recipients.

The timing of this announcement is no coincidence. On Friday, Federal Health Minister Nina Warken (CDU) plans to announce the members of an expert commission. This commission will also advise on benefit cuts in the statutory health insurance system.

Warken announced that there should be no "bans on thinking" in this regard. However, shortly after taking office, the minister expressed sympathy for the proposal to finance contributions for those receiving citizen's allowance entirely from tax revenue.

The chairmen of the administrative board, Dr. Susanne Wagenmann for the employers' side and Uwe Klemens for the employees' side, calculated on Thursday that the federal government still owes the statutory health insurance funds around ten billion euros each year.

This corresponds to 0.5 contribution points. "We want to end the subsidization of the federal budget with insured members' contributions at this point," emphasized the chairmen of the GKV Administrative Board. The board unanimously agreed on this. If the health insurance funds had the missing funds available, the money would be sufficient for care.

200 billion euros in deficits

Since this problem arose, Klemens calculated that up to 200 billion euros in deficits had already accumulated. "A shameless, unbridled raid on the coffers of statutory health insurance," he said after the board of directors had decided to sue for the potential claims.

He has commissioned the GKV-Spitzenverband (National Association of Statutory Health Insurance Funds) to conduct the litigation. "With regard to contributions for citizens' allowance recipients, we are seeing that the state is relieving itself of its burden at the expense of those insured by the GKV," Wagenmann said.

The umbrella association announced that 74 of the 94 health insurance funds, with approximately 70 million insured members, have already backed the lawsuit. The statutory health insurance system has a total of approximately 74.6 million insured members.

The matter was acknowledged in the Bundestag on Thursday. "The lawsuit filed by the GKV-Spitzenverband is a long overdue signal for fair financing of statutory health insurance ," said Linda Heitmann, a member of the Health Committee from Alliance 90/The Greens. The federal government bears responsibility in this regard.

BKK umbrella association speaks of scandal

"The state is failing to fulfill its responsibility," said Dr. Jens Baas, CEO of Techniker Krankenkasse. Baas emphasized that it is the state's responsibility to ensure medical care for people living on the subsistence level in the event of illness.

However, the contributions the state pays to the health insurance funds only cover about a third of the actual costs. The lawsuit therefore raises a "question of justice."

The chairwoman of the BKK umbrella association, Anne-Kathrin Klemm, called it a scandal on Thursday that the federal government plans to simply "fobber off" those with statutory insurance in the current and coming year with loans to support contributions.

Professor Simon Reif of the Leibniz Centre for European Economic Research (ZEW) describes the statutory health insurance contributions for the approximately 5.5 million recipients of the citizen's allowance as a "major lever".

A higher contribution from the Federal Employment Agency for the health insurance of this group of people could provide the health insurance companies and the contributors with a much-needed respite, Reif said on Thursday.

Costs move from one pot to another

However, the head of the ZEW research group “Health Markets and Health Policy” does not consider such a solution to be sustainable: it would simply shift costs from one pot to another.

The discussion about contribution increases ignores the fact that there is enough money in the system. "Germany has among the highest healthcare expenditures in Europe," Reif said. Structural reforms must therefore focus primarily on the expenditure side.

ZEW economist Friedrich Heinemann brought another aspect to the discussion on Thursday. "Just as with contributions for recipients of the citizen's allowance, the question of fair contributions also arises for other insured persons," Heinemann said.

Insured individuals could reduce their contributions by reducing their working hours, so that a female academic working part-time voluntarily pays less than a full-time educator. The statutory health insurance system must address this discussion in light of the increasing proportion of part-time workers. (af)