A mandate to review care and financing
The Federal Ministry of Health (BMG) said the Pflegestrukturkommission, or care structure commission, will develop proposals for good nursing care and sustainable financing that meets care needs. Its recommendations are to form the basis of the planned reform.
Federal Health Minister Carsten Linnemann addressed the start of the commission's work in a statement carried by phoenix on its "phoenix vor ort" program. He said the panel should hear from care providers, municipalities and, above all, people affected by care needs. He also expressed hope that its findings would win broad support.
The ministry has tasked the panel with examining spending trends in Germany's social long-term care insurance system. Alongside financing and improvements in nursing care, it will consider how preventive and rehabilitative services could be used more widely.
Financial pressures and an interim package
In a FAZ interview published by the BMG on September 10, 2026, Linnemann said Germany spends about 75 billion euros annually on care and must now save roughly 10 percent. At the same time, he said, the number of people needing care is expected to grow from about 6 million to 7.5 million by 2050.
The cabinet has already agreed on a care stabilization package as part of legislation to reorganize care insurance, according to a September 30 report by Deutsches Ärzteblatt. Linnemann said the contribution rate would remain at 3.6 percent in 2027. The surcharge for childless members of social long-term care insurance, however, is to rise by 0.3 percentage points to 0.9 percent on January 1, 2027.
The report put the projected deficit at about 4.4 billion euros for 2026 and 7.6 billion euros for 2027. It said the financing gap remained unresolved pending the commission's recommendations.
Who will develop the recommendations
Georg Cremer chairs the 13-member commission, with Gabriele Kuhn-Zuber serving as co-chair. The remaining members are Christine Arentz, Michaela Evans-Borchers, Jürgen Graalmann, Martina Hasseler, Dörte Heger, Stefan Huster, Thorsten Kingreen, Hans-Dieter Nolting, Heinz Rothgang, Gregor Thüsing and Rita Zöllner.
The BMG describes a membership drawn from nursing practice, economics, law, care research, nursing science, care provision and health counseling. ZDFheute reported on October 27 that most members come from academia and specialize in economics or law. Unlike the pension commission, the care panel includes no politicians.
Disagreements over costs and insurance
ZDFheute reported that coalition disagreements have moved into the commission, particularly over two demands from the Social Democratic Party (SPD): a cap on nursing home costs and compensation payments from private to statutory care insurers.
Cremer has previously opposed a general cap on nursing home costs because higher earners would benefit too, according to ZDFheute. He favors higher subsidies for people with greater financial need and reductions for the better-off. Rothgang, by contrast, supports both a cap and financial equalization between private and statutory care insurance.
Deutsches Ärzteblatt reported that the experts must develop proposals for such equalization and assess whether the mechanisms would be constitutionally permissible. The SPD had pressed for that review and threatened to block the cabinet's decision without it.
A proposal for investment-funded coverage
The commission will also examine whether capital-market investments could help fund care insurance, along lines comparable to the "Aktienrente" approach to pensions, ZDFheute reported.
Arentz has proposed an additional mandatory insurance plan called "Pflege+". Under her model, all adults would pay a fixed monthly contribution that would be invested in capital markets. For people who are now 40, the monthly payment would be about 67 euros, with employers covering half.
The proposed insurance would cover up to 90 percent of a nursing home resident's care-related out-of-pocket share. That share amounts to roughly 1,800 euros a month, depending on the federal state.
