Germany plans major long-term care reform via PNOG

The German federal cabinet has approved a draft for the Care Reorganization Act (Pflegeneuordnungsgesetz, PNOG), aiming to restructure long-term care services and address significant financial deficits. Projections suggest that without intervention, the social long-term care insurance system could face deficits of approximately 7.6 billion euros in 2027 and over 15 billion euros in 2028.

Key changes scheduled for January 1, 2027, include a restructuring of care budgets. The current model for respite care (Verhinderungspflege) will be replaced by a system of four distinct budgets based on care levels. Additionally, the threshold points for determining care levels 1 through 3 are expected to rise, which may make it more difficult for individuals to qualify for higher levels of support.

The reform also proposes changes to how care aids are funded. The current separate monthly claim of up to 42 euros for consumables like gloves and disinfectants may be integrated into a broader relief budget. While the government aims to reduce bureaucracy and stabilize contributions, critics, including the Kuratorium Deutsche Altershilfe, warn that tightening eligibility requirements and budget constraints may not provide a long-term solution and could prevent people from accessing necessary preventive care.