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In all ageing economies, long-term care (LTC) is becoming a more pressing political as well as economic issue. As Germany is one of the fastest ageing countries, it has already introduced a LTC insurance scheme of the Bismarckian type in the 1990s. Since its introduction one debate concerning LTC has always been about the generosity and (long-term) financing of benefits.

In the course of this debate about the generosity of LTC insurance benefits, the Merkel administration decided to increase benefits significantly and enlarge the number of possible beneficiaries with the Second LTC Strengthening Act. 1 To finance the reform, the contribution rate was raised from 2.35 to 2.55 per cent and a subsequent increase by 0.5 percentage points in 2019. 2