IPMG Online

The government continues its efforts to provide healthcare services to the Indonesian people through the National Health Insurance - Healthy Indonesia Card (JKN-KIS) program. The government aims to increase JKN participation to 254.6 million people in 2019.

In line with this target, the Coordinating Ministry for Human Development and Cultural Affairs (Kemko PMK) is conducting evaluations and coordination. Due to the JKN funding deficit, Kemko PMK is also improving oversight and reporting mechanisms, monitoring variables, the division of tasks among ministries and agencies, and data-sharing dashboards for the monitoring system.

Another government measure involves mandating that all Indonesian residents enroll in the JKN program by January 1, 2019, at the latest. According to data from the Ministry of Home Affairs, 115 million residents remained unregistered in 2018. However, there are currently no sanctions for those who have not yet registered.

Meanwhile, the Social Security Agency for Health (BPJS Kesehatan) has also implemented strategies to boost participation. First, Presidential Regulation (Perpres) No. 82 of 2018 concerning health insurance facilitates the addition of new participants.

Under this regulation, local governments have the flexibility to register residents without being restricted to only the poor or underprivileged; financially capable residents can also be registered for the JKN program by local governments.

Second, matching Resident Identity Numbers (NIK) from the Population and Civil Registration Agency (Dukcapil) helps BPJS Kesehatan identify residents who have not yet joined the JKN program. "We track down the individuals and provide the data to local governments—pointing out who isn't registered yet—so they can be encouraged to join," explained M. Iqbal Anas Ma'ruf, Head of Public Relations at BPJS Kesehatan.

Furthermore, a third measure involves monitoring companies that fail to report their entire workforce for JKN-KIS enrollment. Oversight is crucial to ensure comprehensive participation coverage among business entities. BPJS President Director Fachmi Idris stated that there are currently 12,606 branch offices and 59,937 ATMs belonging to BPJS Kesehatan’s partner banks (Mandiri, BRI, BNI, and BTN) that facilitate premium payments for JKN-KIS participants. JKN-KIS participants can also pay their premiums via internet banking, SMS banking, EDC machines, auto-debit, mobile banking, minimarket networks, JKN Cadres, Post Offices, Pegadaian (state-owned pawnshops), the Go-Jek app, PayTren, and other channels.

BPJS Deficit

The JKN program embodies the government's commitment to fulfilling the mandates of Law No. 40 of 2004 concerning the National Social Security System and Law No. 24 of 2011 concerning the Social Security Organizing Agency (BPJS).

To ensure the program's continuity, the government injected IDR 10.5 trillion in funds to address the deficit incurred by BPJS, which stemmed from the gap between participant premiums and the payments required to be made to hospitals.

In addition to the capital injection, the government—specifically the Ministry of Finance—implemented several policies. These include the enactment of Minister of Finance Regulation (PMK) No. 183 of 2017 regarding the procedure for settling local government health insurance premium arrears through deductions from the General Allocation Fund (DAU) and/or the Revenue Sharing Fund (DBH).

Furthermore, a policy was established requiring the allocation of at least 50% of the Tobacco Product Excise Revenue Sharing Fund (DBH CHT) to indirectly support the National Health Insurance (JKN) program—such as through promotive and preventive activities and the provision or improvement of health facilities. This policy aligns with the implementation of PMK No. 222 of 2017 concerning the utilization of DBH-CHT.

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