By Kusnandar & Co., Attorneys At Law – Jakarta, Indonesia
The
government’s plan to write off Rp 26.47 trillion in overdue BPJS Kesehatan
contributions is more than a technical fiscal decision—it is a defining moment
for Indonesia’s national health insurance system. The proposed policy,
reportedly awaiting final approval, touches on three fundamental issues: social
justice, financial sustainability, and the state’s responsibility in guaranteeing
access to healthcare.
At its core,
the National Health Insurance (JKN) program was established to ensure that
healthcare is not a privilege, but a right. In principle, it embodies the
constitutional mandate that every citizen deserves access to medical services.
Yet, in practice, millions of participants have fallen into inactive status due
to unpaid premiums. For many, arrears accumulated not out of deliberate
negligence but because of economic hardship, job loss, informal employment
instability, or administrative barriers. When contributions go unpaid, access
to healthcare services can be suspended, placing vulnerable families in an even
more precarious position.
From a
humanitarian perspective, the proposed write-off offers relief to millions of
Indonesians. It provides an opportunity for inactive participants—particularly
low-income, informal sector workers—to regain access to essential healthcare
without the burden of overwhelming debt. In times of rising living costs and
economic uncertainty, such a policy signals that the state prioritizes public
welfare over rigid financial enforcement. It reframes the government not as a
debt collector, but as a social protector.
However, this
policy also raises critical concerns about the long-term sustainability of BPJS
Kesehatan. The JKN system has historically faced financial pressure due to the
imbalance between collected premiums and healthcare claims paid out. The
existence of massive arrears reveals deeper structural issues: inconsistent
premium compliance, weaknesses in contribution collection mechanisms, and
outdated or fragmented participant data. Writing off Rp 26.47 trillion may
resolve an administrative backlog, but it does not automatically solve the
underlying systemic challenges.
There is also
the issue of fairness. Millions of Indonesians have consistently paid their
premiums despite economic difficulties. For them, a blanket write-off could
appear inequitable, potentially creating a moral hazard where participants
perceive that non-payment carries little consequence. If not carefully
designed, the policy may unintentionally weaken payment discipline in the
future. This is why the government must ensure that any debt relief mechanism
is targeted—limited to genuinely vulnerable groups verified through accurate
and integrated social welfare data.
The success of
this policy ultimately depends on accompanying structural reforms. First, the
government should strengthen data integration across ministries and agencies to
ensure accurate classification of beneficiaries and contributors. Second, BPJS
Kesehatan must modernize its collection and monitoring systems, possibly
leveraging digital tools to track contributions in real time and reduce
administrative gaps. Third, public education campaigns are needed to reinforce
the principle that JKN is built on shared responsibility: solidarity works only
when contributions are consistent.
Moreover,
policymakers must treat this write-off not as a one-time political gesture, but
as part of a broader reform agenda. Sustainable universal health coverage
requires predictable funding, improved governance, and transparent
accountability. Without these, similar arrears could re-emerge in the future,
forcing the state into repeated cycles of financial forgiveness.
Rp 26.47
trillion is a significant figure, but the real issue goes beyond numbers. It
reflects the tension between compassion and fiscal prudence, between social
protection and institutional discipline. If implemented carefully and paired
with systemic improvements, the policy could strengthen public trust in the
national health insurance system. If handled poorly, it risks undermining
financial stability and fairness.
Ultimately,
the government faces a delicate balancing act: ensuring healthcare access for
the most vulnerable while preserving the integrity and sustainability of
Indonesia’s universal health coverage system.
By : K&Co - February 11, 2026