Protest against new insurance rules: Psychotherapists warn of longer waiting times

Shortly before the first Bundestag debate on new rules for statutory health insurance, resistance in outpatient care is growing. In Heidelberg, Mannheim, and the Rhein-Neckar district, at least 60 psychotherapeutic practices remained closed on Wednesday as part of a protest action.

On Friday, the Bundestag is scheduled to discuss the draft law to stabilize contribution rates in statutory health insurance (GKV) for the first time. According to the Bundestag, the first reading is scheduled for June 12, 2026. The aim of the reform is to stabilize the financial situation of the health insurance funds and to relieve the GKV by several billion euros in the coming years. However, critics fear that the package will be particularly noticeable where demand is already high: in the provision of psychotherapy.

Protest before the first reading in the Bundestag

The practice closures were part of a nationwide action called for by associations and initiatives from the medical and psychotherapy professions. The timing is deliberately chosen: two days before the first reading in the Bundestag. At the same time, state health ministers also discussed the project on Wednesday.

Regulation to stabilize GKV finances

According to the federal government’s policy, contribution rates are to be stabilized by slowing down the dynamic increase in expenditures. The draft proposes, among other things, the following measures:

• Limitation of remuneration increases
• Review of additional remuneration components

According to the Federal Ministry of Health, the cabinet decision was already made at the end of April.

Therapists fear fewer treatment places

In psychotherapeutic care, criticism is mainly sparked by concerns about new budget limits. Therapists from the region point out that there are already long waiting lists in many places. If treatments are more strictly capped or less fully reimbursed in the future, this could lead to practices accepting fewer statutory health insurance patients.

There is an expectation circulating in practices that in the future, only a limited number of statutory health insurance patients per half insurance seat could be fully reimbursed – a cap of 18 is mentioned. Since many psychotherapists work with a half insurance seat, such a regulation would quickly lead to a bottleneck: For patients above the limit, there would only be a shared, limited reimbursement pool, which could make the economic planning of individual practices more difficult.

Laura Müller, a psychotherapist from Heidelberg, describes the situation as already tense. The waiting lists are full, and the psychological burden in the population has noticeably increased. If people have to wait longer for therapy or cannot find a place at all, this could lead to follow-up costs – for example, through more days of incapacity for work.

Manuel Kieser, a psychotherapist from Eppelheim who, according to his own account, treats children and adolescents, warns that in the worst case, the allocation of places could become "triage-like" – that is, according to urgency, with the consequence that in the end mainly acute emergencies could be treated.

Not only practices: Payers also warn of waiting times

The warning about longer waiting times does not only come from the practices. The GKV-Spitzenverband has also pointed out in a statement on the draft that interventions in outpatient care could reduce treatment capacities and lengthen waiting times. Thus, a savings law intended to stabilize the contribution side meets a care system in which any additional limitation could directly affect patients.

How far the law will ultimately go is still open

There is a fundamental conflict: politicians are looking for quick levers to stabilize GKV financing from 2027 onwards. At the same time, those affected in care warn that savings and dampened remuneration development, especially in high-demand areas, could lead to a reduction in treatment capacities.

Which elements will ultimately be adopted is still open. The parliamentary process is just beginning, and changes are possible. This is exactly what the protesters are counting on: they hope that the protests will still influence the legislative process – before a financial reform leads to noticeable consequences in the everyday lives of patients.