Budget Cuts in 2026: Düsseldorf's STAY! Medinetz Must Fear for the Care of Undocumented People

Ahead of the budget deliberations in the Düsseldorf city council, a long-established medical contact point for people without health insurance is coming under pressure. According to the initiative and consistent local reports, the city's funding for STAY! Medinetz is set to decrease significantly in the 2026 budget—with possible consequences for treatments, surgeries, and the work of the clearing office.

The council of the state capital Düsseldorf discussed the 2026 budget on March 19. According to the available figures, the budget for STAY! drops from the previous 215,000 euros to 160,000 euros. The cut corresponds to about a third. For the initiative, this is not just a matter of a funding amount, but the question of how long a structure can be sustained that organizes medical help for people who often fall through the cracks in the regular system.

What Exactly Is to Be Cut at STAY!

STAY! has been operating in Düsseldorf since 2009. Initially, much was done on a voluntary basis; a more stable, professional foundation was established from 2015, when the city set up a clearing office and an emergency fund. This model is practically designed to ensure that acute care is not left to chance: The clearing office coordinates cases, clarifies possibilities for coverage, and organizes treatments through a network—while the emergency fund covers costs when no one else will sign.

According to the approaches known so far, the previous funding essentially consisted of two blocks:

• 120,000 euros for treatments, medications, and surgeries
• 95,000 euros for staff of the clearing office and overhead costs

In the 2026 budget draft, these funds are reduced to a total of 160,000 euros.

From STAY!'s perspective, this is not a "minor adjustment." The initiative warns that with less money in the emergency fund, what is usually cushioned in the background will become visible first: More people may have to be turned away, and surgeries may increasingly not be financed. In addition, the future of the staff in the clearing office is considered uncertain—and thus precisely the part that organizes access to care in the first place.

Why the Clearing Office Is Crucial for Those Affected

STAY! supports undocumented refugees and people without health insurance with counseling and arranges medical help. The key is low-threshold access: Those who fear being noticed by authorities often avoid doctors' offices and clinics—not out of indifference, but out of fear of consequences and costs that no one will cover. In this area of tension, the clearing office becomes the control center: It ensures that a path to treatment is found at all.

Legally, the situation for those affected and for institutions is complex. Under residency law, public authorities have reporting obligations to immigration authorities (§ 87 Residence Act), while at the same time there are limits due to data protection and confidentiality rules, which are particularly sensitive when it comes to health data (including in conjunction with § 88 Residence Act). In practice, however, for many undocumented people, one thing remains above all: the risk of becoming "visible"—and the resulting inhibition to seek medical help early. This is exactly where STAY! comes in with anonymizing, mediating structures.

How Quickly Very Concrete Decisions Can Be Needed Is Shown by a Current Case

A patient with glaucoma must be operated on soon, otherwise blindness threatens. According to STAY!, the clinic will only perform the procedure if a cost coverage is signed in advance. Such cases make the mechanism behind the budget figures tangible: When the emergency fund shrinks, medical urgency quickly becomes a question of financing—and this then effectively decides whether treatment takes place or not.

The City's Pressure to Save—and Why STAY! Is Caught Up in This Logic

The conflict over STAY! is embedded in an overall tense budget situation in Düsseldorf. The city puts the total volume of the 2026 budget at around 4.4 billion euros. At the same time, the budget is under considerable consolidation pressure: According to the city, an already high deficit in the draft became an even larger annual deficit of around 390.4 million euros in the resolution. The administration also points out that key investments—such as in school construction and transport—must be largely financed by loans and are therefore more dependent on interest and follow-up costs.

Politically, this course is described as prioritization: Investments are to be protected, while consumptive expenditures are to be more closely scrutinized. Representatives of the CDU-Green coalition have announced that the budget situation in 2027 is likely to become even more difficult and further savings will be examined. This is exactly where two perspectives collide. For the coalition, the savings framework is part of a strategy to secure financial capacity to act. For STAY! and supporters, however, the cut means that it is not abstract "project funds" that are decreasing, but a concrete care infrastructure is being weakened—with consequences that can be directly reflected in waiting times, rejections, and unaffordable procedures.

Criticism of the Process—and the Open Question Until the Decision

STAY! criticizes that the cut was made unexpectedly and without warning. Politicians counter that there are discussions and cuts every year and that organizations could inform themselves early about foreseeable changes. This juxtaposition shows what is at stake: planning security. Especially in medical emergencies, care does not work in annual cycles, but in days and weeks—and staff cannot be reliably retained if funding suddenly collapses.

For readers, one thing is therefore crucial: The debate is not about abstract social policy, but about the practical question of whether people without insurance coverage in Düsseldorf will continue to have realistic access to treatment. If the financial leeway for emergencies and the capacity of the clearing office both decrease, the service will likely become more limited—and in particularly expensive or urgent cases, will first reach its limits.

Whether the cut remains as it is or is adjusted by the council will therefore decide not only a budget item, but the reach of a system that has been closing a care gap for years. In a budget that is under overall pressure, STAY! becomes a test case for which protective mechanisms a municipality maintains even in times of austerity.