German statutory health insurers post €2.6 billion surplus despite rising costs

Germany’s 93 statutory health insurers posted a €2.6 billion surplus in the first half of 2026, but the result offers little comfort about the system’s longer-term finances. The surplus followed contribution increases at the start of the year and mainly served to rebuild reserves.

The insurers ended June with reserves of about €7.5 billion. Across all funds, that restored the legally required minimum average of 0.2 months of expenditure. Yet spending continued to grow substantially faster than income, according to the Federal Health Ministry.

Health Minister Carsten Linnemann said the figures provided no reason to relax. “This development must be stopped to break the contribution-rate spiral,” he said. The governing coalition’s contribution-rate stabilisation law, passed in July, aims to hold the average additional contribution rate at 2.9% next year. It calls for about €19 billion in savings.

Spending restraints for doctors’ practices, hospitals, pharmacies and the pharmaceutical industry are due to take effect at the start of 2027. Patients will also face higher co-payments for some medicines.

From January through June, the insurers collected €188.9 billion and spent €186.3 billion. Spending on medical services rose 7.4%, slightly below the 7.7% increase recorded in the same period a year earlier, but still well above the long-term average. Hospital treatment costs rose 9.3%, or €5.1 billion, making them the biggest driver. Outpatient medical care increased by 6%, or €1.63 billion, while pharmaceutical spending rose 5.1%, or €1.5 billion.

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This development must be stopped to break the contribution-rate spiral.