DAK-Gesundheit Joins Lawsuits Against Federal Goverment Over Health Fund Allocations & Citizen’s Benefit Costs
DAK-Gesundheit,a statutory health insurance company,is filing a lawsuit against the federal government on Monday,alleging inadequate funding from the health fund and deliberately increased health insurance contributions impacting insured individuals. This action adds to a growing wave of legal challenges brought by statutory health insurance companies against the government.
According to DAK-Gesundheit CEO andreas Storm, the lawsuit specifically targets the current notifications regarding insufficient allocations from the health fund for 2026. “We demand adequate financing of the allocations for citizens’ benefit recipients,” Storm stated to the “Bild” newspaper. He argues that if statutory health insurance companies received the full ten billion euros in federal funds they are entitled to annually, contribution rates could remain stable in 2026, resulting in a relief of 0.5 contribution points.
The case will be filed with the State Social Court of North Rhine-Westphalia, which has first instance jurisdiction.
This lawsuit follows a similar action taken by the National Association of Statutory Health Insurance Funds in September. That lawsuit centers on the federal government’s failure to fully finance the treatment costs of citizens receiving citizen’s benefit. The association estimates this financing gap to be around ten billion euros per year. Data indicates that nearly half of citizens’ benefit recipients are foreigners.
currently, statutory health insurance companies recieve a flat-rate contribution of 133.17 euros per month for each member receiving citizen’s benefit,an amount adjusted annually. However, a 2022 report commissioned by the National Association of Statutory Health Insurance Funds revealed that this flat rate needed to be almost three times higher to adequately cover the actual costs of care.
The financial health of statutory health insurance companies has been strained for years. Estimates project a deficit of 6.2 billion euros for 2024, leading to notable contribution rate increases at the beginning of the year – the largest increase in at least 50 years.
In response to a declining liquidity reserve in the health fund (which receives contributions from legally insured members, employers, and tax revenue and then distributes funds to health insurance companies), the federal government provided a short-term subsidy in the spring.
Source: DO/sin (as indicated in the original article)