News from the care "reform" - an evaluation of the proposals of the federal-state working group

In August 2025, we published a collection of texts on the current discussion about reforming long-term care insurance on our website. In mid-December, the federal-state working group, which had been working on proposals for changes to long-term care insurance benefits and their financing since July, presented a report, which is expected to result in a draft law that will enter into force this year. In principle, the draft presented confirms previous perceptions:

What is understood by the term "care crisis" is currently being shifted by the government and business organisations. While this was previously understood to mean a lack of care and deficiencies in social security in the event of a need for care, such as a lack of places in care facilities, a shortage of skilled workers, overwork and the risk of poverty for family carers, this is being turned on its head in the "turnaround": The costs of care were a burden on the competitiveness of companies, "the business location", and urgently needed to be reduced. "Care crisis" no longer means that those dependent on care and those who provide care both professionally and unpaid suffer from the half-heartedness of society's burden-sharing. Instead, it is suggested that companies themselves can no longer afford this far too low level of institutional solidarity.

The task of the federal-state working group was therefore, on the one hand, to change care provision with the aim of reducing costs. According to the current proposals, this will particularly affect care households. On the other hand, additional income is to be generated. Here, the report shows, among other things, that even cautious proposals in the direction of a more solidarity-based policy, such as making high wage incomes pay more, would be particularly effective. This, in turn, is not desired by the relevant political forces. As a result, there are no proposals for funding; this part is left to the federal government.

Conclusion: If we leave the issue of 'care' to the government, it won't get any better. Criticism, protest and self-organisation are essential.

We have now integrated a brief evaluation of this final report into our collection of texts (p. 19-22). You will find the link at the end of the article. It already contains a reference to an expert report commissioned by the Alliance for Full Long-Term Care Insurance based on Solidarity. It shows that genuine full long-term care insurance would be possible without increasing contributions if all income, including capital income and wage income above the current assessment threshold, were taken into account (pp. 16-17 of the text collection, with a link to the full text of the report).

However, the concerns of family carers in particular are also neglected in this report. The aforementioned report focuses on the burden on care households due to care costs, e.g. personal contributions for places in care homes, but does not take into account the fact that family carers currently carry out care work at home without any real security, which is hardly possible alongside (full-time) gainful employment. They are therefore faced with the choice between overwork on the one hand and poverty or poverty in old age on the other. A pilot project in the Austrian province of Burgenland, which is presented in a study by the Rosa Luxemburg Foundation, attempts to remedy this situation by employing family carers through a state company (p. 18 of the text collection, with a link to the study).

A contribution by Silvia Klein and Matthias Neumann

In our dossier you will find:

1) Development of long-term care insurance and current status (basic information): S. 3-4

2) Attempt to categorise the changes in long-term care insurance (text Brief overview of the situation in elderly care. Created in 2023 for the discussion in the Care Revolution regional group in Freiburg, figures updated): S. 5-8

3) Closure of care facilities (article Closure of care facilities. Not a by-product of a "wave of insolvencies", but system failure, published on the Care Revolution website in April 2025): S. 9-12

4) Overview of current care insurance reform proposals: p. 13-18

New: 5) Comments on the report of the federal-state working group "Zukunftspakt Pflege": Brief evaluation of the December 2025 report and the proposals and gaps contained therein: p. 19-22