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HEALTH

Do Germany’s planned changes to abortion laws go far enough?

A long-awaited change to Germany’s punitive abortion laws is underway, but some believe it stops far short of what's needed. Here’s what you need to know.

Do Germany's planned changes to abortion laws go far enough?
A woman receives a consultation at a catholic pregnancy advice centre in Baden-Württemburg. Photo: picture alliance/dpa | Marijan Murat

In January this year, Germany’s traffic light coalition – made up of the Social Democrats, Free Democrats and Green party – announced its intention to undertake “the biggest reform of family law in several decades”, introducing sweeping protections for same-sex couples and non-traditional families.

Centre-stage in these reforms was a drastic overhaul of Germany’s outdated reproductive laws – stripping away a controversial clause on advertising abortion that has remained unchanged since the 1930s.

Discussing the move, Justice Minister Marco Buschmann (FDP) said the current state of abortion law in Germany created an “unacceptable situation” where doctors faced criminal proceedings for trying to help people stay informed. “That doesn’t belong in our times,” he said.

On the face of it, it seems like the long decades of feminist campaigning has paid off. But a closer look at Germany’s current abortion laws suggests that the planned reforms may only scratch the surface. 

What’s are the current abortion laws – and how will they change? 

Once of the most controversial aspects of current abortion law in Germany is Paragraph 219a, a Nazi-era clause forbidding doctors from “advertising” the availability of abortion services or sharing information on the procedure with patients. 

The government has promised to dispense with this paragraph and, earlier this year, Buschmann announced that the cabinet had agreed on a draft bill to do just that. With this initial move to allow doctors to provide information to pregnant patients, the long road to reform has already begun.

READ ALSO: Why Germany is planning to overhaul abortion information laws

However, the much-publicised and in-the-works repeal of Paragraph 219a is only one piece of the many barriers to abortion in Germany. At present, the coalition has not announced a formalised intention to abolish Paragraph 218, which continues to fundamentally criminalise abortion, leaving pregnant women to manoeuvre within tightly-defined exceptions to the law.

A pro-choice protester in Berlin wears a mask with "away with §218" on it.

A pro-choice protester in Berlin wears a mask with “away with Paragraph 218” on it. Photo: picture alliance/dpa | Paul Zinken

The prospect of changing this status quo remains murky, couched in extremely careful language. The coalition contract does clearly state that access to cost-free abortions should be a part of reliable healthcare. But when it comes to fully decriminalising the act of abortion, the document only announces that a commission on reproductive self-determination and reproductive medicine will examine options for regulating abortion “outside of the framework of the criminal code”. No concrete promises there.

Katrin Helling-Plahr, FDP parliamentary group spokesperson for legal policy, was actively involved in negotiating this section of the coalition contract. Plahr has long advocated for more progressive laws on reproductive medicine, and greeted the demise of Paragraph 219a as long overdue

Responding to a request for comment on the coalition’s cautious language, she reiterated plans to appoint an exploratory commission, but made clear that her party did not necessarily regard a total decriminalisation of abortion as legally or ethically viable. 

We Free Democrats are of the opinion that Paragraph 218, as the result of a long societal discussion, represents a successful compromise with regards to protecting the life of the foetus and the right to self-determination of the pregnant person,” she wrote.

Abortion access remains fraught

Meanwhile, individuals seeking to terminate a pregnancy in Germany are often left with little choice but to travel abroad for care, to one of the many European nations with fewer barriers to abortion. 

As long as Paragraph 218 stands, those seeking legal abortions in Germany face mandatory and often aggressively pro-natalist counselling, a waiting period and strict time limitations, with abortions only available in the first 12 weeks of pregnancy. And even when eligible for a legal abortion, finding a provider to perform it is another matter entirely. 

A recent story from investigative news site CORRECTIV.Lokal showed the barriers faced by individuals seeking to terminate a pregnancy in Germany, including poor access to abortion providers, discriminatory treatment, patchy insurance coverage of the costs and extensive bureaucratic burdens. As the Green parliamentarian Ulle Schauws pointed out, despite more readily available information on performing doctors after the removal of 219a, the actual sparse landscape of abortion coverage won’t automatically become any more densely populated.

The difficulty of accessing contraception 

Abortion access isn’t the only thorn in the side of folks who would rather not be pregnant. 

In 2015, Germany finally made the morning-after pill available over the counter, without a prescription. Though many people are able to obtain it without too much hassle, there’s evidence to suggest that different pharmacies handle the situation differently – with some taking a more invasive approach. 

When US citizen Courtney Harrison tried to get emergency contraception at a German pharmacy, she found the experience intensely personal and far removed from the ease of obtaining most other over-the-counter medications. Before being given the medication, she was brought back to a separate room and had to speak with multiple staff members. 

“They had to ask a bunch of questions and I had to fill out a form,” she said, questioning the necessity of sharing “intimate details” with two different people just to obtain an over-the-counter medication. 

A woman holds the morning-after pill at a pharmacy

A woman holds the morning-after pill at a pharmacy. Photo: picture alliance/dpa/dpa-tmn | Benjamin Nolte

“I hope people who need Plan B here in Germany don’t face judgement when they have to personal answer questions about their reproductive health and sex history. I felt embarrassed and overwhelmed,” she added.

While reforms to access to contraception aren’t specifically on the cards, the traffic light coalition has pledged to ease the financial burden of obtaining it.

In the coalition pact, the parties say they want to give health insurance companies the ability to cover the cost of regular contraception “as a statutory benefit”, as well as making free contraceptives available for those on low incomes. Emergency contraception is already covered by health insurance – but only after a visit to the GP. 

They also want to invest in research for contraceptives “for all genders” – presumably including the much-awaited pill for men. 

READ ALSO: What you need to know about the abortion law battle that divides Germany

Do the reforms go far enough?

Though the traffic-light coalitions have made pledges that go far beyond anything posited by the previous conservative-led government, some campaigners question whether the changes set out will be enough to make a meaningful difference. 

At present, potential expense, legal issues and a mountain of bureaucracy often limit women’s access to reproductive healthcare. That, and the ever-debated Paragraph 218, that continues to consider abortion a criminal offence. 

“In Germany my body belongs, de facto, to the state,” journalist and campaigner Mithu Sanyal said in an interview with Deutschland Funk. “You can see that in a law like Paragraph 218: the state can decide whether I get an abortion or not.”

Though the coalition has also pledged to make abortions free of charge and tackle the information and access issues, the legal issues remain a sticking point. 

Speaking to broadcaster RBB24, Sabrina Odebrecht, who works at a pregnancy advice centre in Berlin, said she thought it was right for women to be offered counselling before an abortion. But, she added, they should have the right to choose whether to accept it without fearing legal consequences. 

“I think it is wrong to criminalise the procedure in principle, to criminalise and frighten women and doctors,” Odebrecht said. “That is why Paragraph 218 should finally be dropped.”

So despite the incoming changes, the debates surrounding abortion law are far from over. 

Member comments

  1. I wonder are these pro choice people and ministers the same ones who want to force people into vaccination?
    Everyone should have a choice. But I dont think abortion should be touted as a cure all. Decriminalise it and allow the parties involved to openly discuss options. It just can not be made too easy it is a very serious thing. Not a quick fix.

  2. Florida just changed their law and I find it reasonable. It gives women an option, but not an open-ended one that takes into account fetal development.

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HEALTH

How much more residents in Germany might have to pay for health insurance

People in Germany saw an increase in health insurance costs at the start of the year. It's now expected that they will be hiked up again next year.

How much more residents in Germany might have to pay for health insurance

Health insurance organisations are warning that costs will be hiked up again soon due to concerns over funding. 

Doris Pfeiffer, CEO of the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband), told Germany’s Tagesschau that insurance funds are expecting a billion-euro deficit.

She said it was a tough year “because we don’t have particularly good prospects”.

For people paying statutory health insurance, things could become more expensive next year. Around 90 percent of people in Germany are covered by statutory health insurance.

The contribution rate is fixed by law and stands at 14.6 percent. The additional contribution that the health insurance funds set for their members was raised to 1.7 at the start of this year. 

The latest increase gave statutory insurance funds the ability to charge up to 1.7 percent on top of the standard 14.6 precent contrinution, though not all insurance funds chose to do so.

The costs are split between the employer and employee, so workers in Germany would pay half of any increase. 

READ ALSO: Reader question: How can I change my German health insurance provider?

How much could additional costs rise next year?

Due to the funding issues, health insurers expect an increase of up to 0.6 percentage points to the additional contribution threshold. What this would mean for the insured depends on a few variables such as their income and their insurer.

Someone earning €2,000 gross per month, for example, would have to pay €6 extra per month if their insurer opted to increase additional contributions by this amount. Meanwhile, a gross income of €4,000 would mean €12 extra per month. The employer’s share would be added to this. 

health insurance cards

Many health insurance cards in Germany double as a European Health Insurance Card (EHIC), meaning that they can be used across Europe. Photo: picture alliance/dpa | Jens Kalaene

“That may not sound like much at first glance,” said Pfeiffer. “But there are people who earn very little for whom this is a lot – supermarket cashiers, lorry drivers.”

It comes following a rise in fees at the start of the year. From the start of 2024, additional contributions for statutory health insurance rose by around 0.1 percent in Germany.

Why are costs increasing?

The German healthcare system is one of the most expensive in the world.

As German society ages more, costs continue to rise – and the Covid pandemic didn’t help matters. The National Association of Statutory Health Insurance Funds estimates that this year alone it will cost around €314 billion to provide care for everyone who is insured. 

The money is mainly spent on hospitalisation costs and medical treatment.

READ ALSO: Why long-term care insurance fees are likely to rise in Germany next year

Health Minister Karl Lauterbach (SPD) has so far not presented any concrete proposals on how he intends to relieve the burden on health insurance funds in future.

Instead, the system is likely to face further expenditure. Lauterbach’s hospital reform is expected to drive up costs, while proposals to pay GPs more in order to combat the shortage of doctors would also push up expenses. 

READ ALSO: German ministers greenlight plan to improve healthcare at GPs

Pfeiffer called for a plan to tackle the rising costs.

“We now finally need an approach that puts this healthcare system on a new footing,” she said.

In the coalition government’s initial agreement back in 2021, the parties vowed to support health insurance funds with more tax revenue.

But as difficult budget negotiations take place, it doesn’t look like this will happen. 

This is causing friction among the coalition made up of the Social Democrats (SPD), Greens and Free Democrats (FDP). 

Green budget politician Paula Piechotta, for instance, is unhappy about this.

The opposition CDU/CSU also taken the opportunity to swipe at the government.

“This is not acceptable,” said CDU health politician Sepp Müller. “The tense situation in the social security system cannot continue to be ignored.”

However, it should be noted that there was no plan to help provide more money to statutory health insurance under the previous Health Ministry headed by the CDU’s Jens Spahn. 

When the SPD’s Lauterbach took over in 2021, there was already a funding gap of billions of euros. 

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