Germany’s governing coalition has agreed on revisions to a planned hospital reform, Health Minister Nina Warken (CDU) confirmed this week, a move that follows concerns raised by Green Party politicians and regional governments about the potential impact on healthcare access.
The reform, initially launched under the previous government, aimed to address financial pressures on hospitals and encourage greater specialization in complex medical procedures. However, the network of approximately 1,700 clinics nationwide was anticipated to shrink prompting a reassessment after the current black-red coalition – comprised of the CDU, CSU, and SPD – took office.
A key element of the revised plan, as outlined in a coalition agreement finalized in April 2025, centers on completing the hospital reform by summer 2025. The agreement stipulates that the responsibility for granting exemptions to ensure continued access to essential clinical services – including internal medicine, surgery, gynaecology, obstetrics, and emergency care – will remain with the individual federal states.
The coalition agreement prioritizes stabilizing contribution rates for statutory health and long-term care insurance, but lacks specific measures to achieve this goal. Plans to fully fund non-cost-covering statutory health insurance contributions for benefit recipients through tax revenues, as previously considered, have been dropped. Similarly, the reimbursement of €5.22 billion withdrawn from the compensation fund during the coronavirus pandemic, intended to stabilize long-term care insurance, is no longer included in the current agreement.
Instead, the coalition intends to improve the financial position of statutory health insurance funds by increasing employment levels and reducing expenditure. An expert commission is slated to evaluate healthcare policies by spring 2027 and propose further measures, indicating a lack of immediate structural reforms.
Green Party politicians have voiced concerns about potential changes to the reform, warning against any measures that could compromise access to healthcare services. The revisions come as hospitals face ongoing financial challenges, and as discussions continue regarding the long-term funding of the healthcare system.
The agreement does not address the specific challenges faced by hospitals serving vulnerable populations, such as Martin Luther King Jr. Community Hospital in South Los Angeles, which relies heavily on Medicaid patients. Nor does it detail how the reforms will address systemic health disparities affecting communities of color, as highlighted in recent reports examining the impact of government decisions on Black health in regions like South Carolina.
