The claim that refugees are pushing the German healthcare system into crisis remains persistent – especially within AfD circles. She also repeated this stance on X (formerly Twitter) on June 20, 2025, in stark terms: A long-overdue step that the AfD has been demanding for a long time. But it is not enough: Mass immigration into our social systems must finally be stopped, or an imminent collapse is looming. Welfare state and open borders are mutually exclusive!
But Weidel’s portrayal is not only populist – it is simply false. Refugees are not regularly insured under the statutory health insurance system.
How are refugees provided with medical care?
Special regulations apply to refugees in Germany. Their medical care is not handled through the statutory health insurance system but through the Asylum Seekers' Benefits Act (AsylbLG). This law stipulates that asylum seekers are entitled to basic medical care – including:
Treatment of acute illnesses
Care during pregnancy and childbirth
Necessary vaccinations
But unlike regular insured individuals, refugees do not pay contributions to a health insurance fund – they are not members of the statutory health insurance system. Although they receive a health insurance card after a certain waiting period, the costs are not covered by the insurance fund itself but by the municipal social welfare offices. This also means that refugees do not pay into long-term care or pension insurance and therefore have no entitlement to these benefits. Only certain groups – such as children, apprentices, or refugees from Ukraine – receive direct access to statutory health insurance through the citizen’s benefit (Bürgergeld). In addition, according to the Fifth Book of the Social Code (SGB V), there may be special regulations in some federal states if the respective state governments enter into agreements with health insurance providers.
Why are health insurance contributions really rising?
The thesis that refugees are responsible for rising health insurance contributions does not hold up. The health insurance funds themselves cite completely different reasons for the financial shortfalls:
Exhausted reserves: Under former Health Minister Jens Spahn (CDU), health insurers were forced to deplete their reserves to avoid a contribution increase during his term. Underfunded social benefits: The health insurance funds receive too little tax money for the medical care of citizen’s benefit recipients and pensioners.
Hospital reform: The reform became legally binding at the start of 2025 and is being rolled out gradually through 2029. It is financed half by the statutory health insurance system – a model that is legally and politically controversial. Legal challenges to this GKV-based financing are ongoing – final clarity has yet to be reached.
In fact, working migrants even help stabilize the health insurance system. As many of them are integrated into the labor market and pay regular contributions, they relieve the system rather than burden it.
A populist fairy tale
Alice Weidel’s claim that refugees are the main reason for rising health insurance contributions is not only false but a deliberate attempt to stoke resentment. The real causes lie in political decisions and structural financial problems within the healthcare system. The facts are clear: refugees are not regularly insured under statutory health insurance, they do not pay health insurance contributions – and therefore are not responsible for rising contributions.
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