Spending in Germany’s statutory health insurance system (GKV) is projected to increase significantly more than its revenue this year. According to an estimate from IT provider Bitmarck, which was reported by the “Rheinische Post”, the costs are expected to rise by seven percent in 2026, following a 7.8 percent increase in the previous year. However, revenue growth is set to remain substantially below these figures. While revenues grew by an estimated 3.7 percent in 2025, an increase of six percent is anticipated for the current year. As a result, the deficit in the Health Fund is projected to climb to 59 billion euros this year, up from 52 billion euros recorded by Bitmarck in 2025. The authors characterize this situation as representing a “high structural deficit”.
Furthermore, the solvency of the health funds remains a concern. In 2025, nearly 60 percent of the participating health funds were operating with reserves below the required minimum. This minimum reserve is equivalent to 20 percent of a month’s expenditure and is intended to manage fluctuations in spending and stabilize supplementary contributions. Although efforts to raise contributions are expected to reduce the percentage of funds below this threshold by the end of the year, Bitmarck predicts that even by the end of 2026, every third health fund will still lack adequate minimum reserves. Separately, the Federal Cabinet had passed a legislative draft for the GKV reform at the end of April. This reform is intended to cover the deficits within the health funds and maintain the stability of contributors’ payments in the coming year.