Pregnancy: CSU opposes more state-funded abortions

The SPD has long sought to legalize abortions, while the CDU/CSU sees the current counseling regulations as a sufficient solution. The SPD and CDU /CSU have agreed to a reform in their coalition agreement, but the exact details the parties have agreed to are controversial within the coalition.

The coalition agreement states the following regarding abortions: "We will expand the coverage of costs by statutory health insurance beyond current regulations." The SPD sees this as an indirect resolution to repeal Section 218 of the Criminal Code, which initially criminalizes abortions and allows them to remain unpunished only under certain conditions. The CDU/CSU, on the other hand, sees the sentence as merely a promise that the state will pay for abortions without penalty for more women than before.

However, there is also resistance within the ranks of the CDU/CSU. "I personally consider health insurance companies to be constitutionally questionable if they cover costs beyond the current regulations, and in my opinion, this would undermine the norms of Section 218," said CSU Bundestag member Stephan Pilsinger to the Süddeutsche Zeitung . "The CDU/CSU will not abolish or weaken Section 218," said Pilsinger, who is deputy chairman of the Health Committee.

The Federal Statistical Office counts around 100,000 abortions per year in Germany . Women generally have to pay for the procedure themselves. The Pregnancy Conflict Act stipulates that these costs can be covered if the woman has little money. Since July, the net income limit has been €1,500 per month, according to the Association of Statutory Health Insurance Funds. The threshold generally rises annually. If you have children, the limit increases; rent may also be taken into account.

Women must apply for reimbursement from their health insurance provider. TK, Germany's largest health insurance provider, recommends that women visit a customer service center and bring their most recent pay slip and a current bank statement. However, abortions are not paid for with the insurance providers' money: The insurance providers, in turn, receive reimbursement from the federal states.

In 2022 , a research group based at Fulda University of Applied Sciences surveyed around 600 women who had unintentionally become pregnant and had abortions about the costs. Around 60 percent of respondents applied for and received reimbursement. Around seven percent were denied reimbursement. The remainder did not apply. The women surveyed often estimated the costs at around €300 or €400. They also reported that the costs of abortions are higher if it is difficult to obtain the procedure in their region. Travel costs may also be added.

The discussion about how the sentence in the coalition agreement should be understood was initiated by lawyer Frauke Brosius-Gersdorf, nominated by the SPD for the Federal Constitutional Court. After her election was canceled at the last minute, she said on Markus Lanz's TV show that she understood the sentence in the coalition agreement as "an expansion of the statutory health insurance's obligation to provide benefits." According to the case law of the Federal Constitutional Court, there should only be an obligation to provide benefits for an abortion if it is legal. In other words: the coalition agreement indirectly decided to delete Section 218. Many in the SPD supported this view.

Federal Health Minister Nina Warken (CDU) contradicted this interpretation over the weekend. "That's certainly not what's meant," she told the Berliner Morgenpost . Instead, Warken pointed out that cost coverage is already possible. "It's conceivable to raise the current income limit for this," Warken said. "There's no need to change abortion law Section 218 for that."

Warken's statement is shared within the CDU/CSU parliamentary group—but not by everyone, as the objection raised by CSU MP Pilsinger demonstrates. His legal interpretation is more in line with that of Brosius-Gersdorf and the SPD, namely that Section 218 and the assumption of costs are closely related. He simply comes to the opposite conclusion, namely that the existing construct precludes the state from paying for more abortions than before. Pilsinger's remark that he shares his "personal" view is an indication that the issue can be a matter of individual conscience for MPs. The conservative-red coalition only has a 13-seat majority in the Bundestag.