Care reform decided: More support, higher costs – politics

Care reform decided: More support, higher costs – politics

On Friday morning, the Bundestag care reform decided. For most insured persons, the contributions to long-term care insurance will increase significantly, but at the same time the benefits will also be expanded with this law from the house of Federal Health Minister Karl Lauterbach (SPD). What contributors, those in need of care and their relatives need to know.

For whom are the contributions increasing?

As of July 1st, the contributions for the care insurance raised. The general contribution rate is to increase from the current 3.05 percent to 3.4 percent of gross income. Then there are surcharges or deductions depending on the life situation: people who have no children of their own are charged more, they pay four percent. Parents with one child pay the normal contribution, for each additional child the contribution is reduced by 0.25 percentage points.

With two children, 3.15 percent is deducted from the gross wage, with three children 2.90 percent, with four children 2.65 percent. With five or more children, you reach the lower limit of 2.4 percent care contribution. However, these deductions from the second child only apply as long as the child to be taken into account is under 25 years of age. For older children, the standard contribution of 3.4 percent applies to the parents.

Why is the contribution structure changing?

Because there is not enough money. When it comes to long-term care, everyone – from employees to caregivers to service providers – complains about insufficient funding. The rising contributions are expected to increase the income from long-term care insurance by 6.6 billion euros annually. When presenting his plans, the Federal Minister of Health already put the “structural deficit”, i.e. the existing underfunding, at around 2.6 billion euros. The remaining four billion euros are to be used to improve long-term care insurance benefits.

In addition to the financing problem, a judgment by the Federal Constitutional Court last spring was also decisive for the reform: the judges ruled at the time that parents with several children should be relieved more – this is now reflected in the contribution structure.

What benefits do people who are cared for at home receive?

About four fifths of those in need of care in Germany are cared for at home. Care is mostly provided by relatives, sometimes with support from nursing services, sometimes not. The support services in these cases will be increased by five percent in all areas at the beginning of 2024: The care allowance is currently between 316 and 901 euros per month and will be increased, as will the so-called benefits in kind for people who are cared for by mobile care services. Depending on the level of care, these are currently between 724 and 2095 euros.

Is there additional support?

Yes. At the last minute, the coalition agreed this week to reintroduce the so-called relief budget into the law, which was agreed in the coalition agreement but had since been canceled during the course of the negotiations. With the relief budget, those in need of care and their relatives can flexibly combine the services of respite care (previously: 1612 euros) and short-term care (previously a maximum of 1774 euros) and use the services amounting to 3539 euros per year.

This should make it easier for relatives to take a break while the care of the patients is still ensured. The regulation applies from July 1, 2025. The families of children in need of care with care level 4 or 5 can use this regulation from January 1, 2024, initially with an upper limit of 3386 euros, from July 2025 it will also be raised to 3539 euros.

What help is there with accommodation in care facilities?

People who are cared for in nursing homes generally have to pay part of the costs themselves. The state provides subsidies for this personal contribution, which are based on how long the person in need of care has been accommodated in a facility. The following rates will apply from 2024: In the first year of residence, the state will in future pay 15 percent of the personal contribution (instead of the previous five percent). In the second year, 30 percent are paid (previously 25 percent), in the third year 50 percent (previously 45 percent) and from the fourth year 75 percent (instead of the previous 70 percent).

What will change for employees who care for relatives?

The paid care days for working relatives are to be expanded. Previously, employees could only take ten days off for each relative in need of care. After a corresponding application, a care support allowance based on the net wage is paid for this time. In the future, ten days of care should be made possible in each calendar year for each relative in need of care.

How long will the new rates apply?

The amount of the support payments is to be adjusted again in early 2025 and 2028 to reflect price developments. However, the contributions could also continue to rise: In the future, the federal government can increase the care contributions by statutory order in order to be able to react quickly to financial difficulties in the care insurance.

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