Hartz IV draft law: rescue for private health insurance?

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Is the federal government planning new bailout packages for private health insurance? Hartz IV recipients who are covered by private health insurance should be forced into the statutory health insurance. Politicians and health insurance companies criticize the considerations of the Federal Ministry of Labor.

Despite the denials, the latest plans from the federal government are on the table: the black-and-yellow coalition wants to force Hartz IV recipients into the statutory health insurance scheme in favor of private health insurers or force the private health insurance provider to offer a tariff specifically for Hartz IV recipients. Numerous politicians are demanding that the shortfall be financed from tax funds. The health insurance companies were outraged and also demanded compensation from the state for the coverage gap.

Numerous politicians and health insurance representatives suspect that the new plans are a bailout in favor of private health insurance. The background to the debate is a legislative proposal by the Federal Ministry of Labor. This text - which numerous agencies already have - deals with the financing of health insurance for people who receive benefits under SGB II (Hartz IV). The employment agencies only cover the cost of statutory health insurance for those affected. This is 126 euros a month. Half the maximum rate of the private health insurance is 290 euros on average, depending on the tariff. The difference must be paid by recipients of social benefits from the standard benefits themselves. However, numerous social courts have given this practice a clear rejection and judged that the costs for a basic tariff must be borne by the labor union.

The Federal Social Court in Kassel will rule on this in January. That is why the Federal Ministry of Labor is now obliged to forge a draft law, which favors two variants. One says that the PKV should be obliged to offer a basic tariff for Hartz IV recipients, the amount of which is equal to the capped GKV tariff. In the second variant, it is suggested that Hartz IV recipients be obliged to switch to the statutory health insurance. For their part, the health insurance companies should be obliged to accept former PKV insured persons.

Politics in favor of private health insurance? In both variants, the federal government is again suspected of pursuing a clientele policy in favor of the private health insurance. First the access conditions for the change of high earners into private health insurance were facilitated, now Hartz IV recipients are to be forced to switch to the SHI. Such a regulation is not well understood by the representatives of the health insurance companies. The spokesman for the umbrella organization of statutory health insurance companies, Florian Lanz, said: "One could almost get the impression that this should be the next support measure for private health insurance companies suffering from premium increases."

But the problem as such needs to be resolved. Many Hartz IV sufferers no longer know how to escape the cost trap. Thousands can no longer pay their bills now because the low standard rate of 359 euros is no longer sufficient for contributions from the private health insurance. According to experts, premium arrears will have grown to 400 million euros by the end of the year. The Association of Private Health Insurance Companies also intervened in the ongoing discussion. Their boss, Volker Leienbach, demands that the employment agencies take over the premiums in full instead of the proposed variants. These demands can also be confirmed by the judgment of the Federal Social Court expected in January. Health economists estimate that this would cost taxpayers around 20 million euros annually. Not a big sum, actually. But politicians are now afraid that with such a regulation, the statutory health insurance companies will run wild and also demand the full share of the costs for health insurance. This in turn can cause annual costs of around 200 million euros.

However, the Federal Government does not want to raise such a sum. That is why this variant is not even formulated in the draft. It would therefore be better for the state budget to push the long-term unemployed into the statutory funds. Such a measure would significantly relieve the PKV system. In the end, the victims of this regulation would be the members of the statutory health insurance companies. According to the GKV Verband, the health insurers would already raise a subsidy of 60 euros for each Hartz IV recipient. If the affected Hartz IV recipients were now forced into the statutory health insurance system, the additional cost share would skyrocket. This could result in rising contributions in the form of additional contributions. The GKV spokesman therefore asked the legislator to pay "health insurance contributions" for Hartz IV recipients as well.

The General Local Health Insurance Fund (AOK) was particularly keen on the draft law. "Political health insurance must not be misused as a rescue fund for private health insurance," said Jürgen Graalmann, deputy chairman of the AOK federal association. Here you are finally asked to create justice. Either the private health insurance company must also cover the gap in unemployment benefit II recipients, or "the health insurance companies also receive a higher grant for Hartz IV recipients, as required by private health insurance."

In the Federal Ministry of Labor, efforts are made not to let the matter boil over. A spokesman denied that a complete bill is already available. One would currently speak with the Federal Ministry of Health about a uniform regulation. (sb)

Also read:
SHI relocation of Hartz IV recipients?
Arge has to pay PKV contributions at Hartz IV
Takeover of PKV contributions for Hartz IV recipients

Photo credit: uschi Dreiucker / pixelio.de

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