Senator Filep: Regarding the BPJS Deficit, JKN System Reform Must Be Implemented Immediately

03 September 2026 oleh admin

Jakarta, dpd.go.id - Committee III of the DPD RI views that the financing issue of the National Health Insurance (JKN) managed by BPJS Kesehatan has entered a stage that requires systemic improvements and cannot be resolved sufficiently with short-term policies.

This issue is increasingly pressing as BPJS Kesehatan (Social Security Agency for Health) is currently facing financial pressures of approximately Rp 2 trillion (approximately US$1.2 billion) per month. Healthcare claim payments reach approximately Rp 16–16.5 trillion per month, while contribution revenues hover around Rp 14 trillion per month. This situation indicates a structural gap between revenue and service costs.

"Committee III of the House of Regional Representatives of the Republic of Indonesia (DPD RI) assesses that this issue is a matter of the resilience of the national social security system, not just a matter of BPJS finances. Furthermore, this is not just a deficit, but also concerns the public's rights, as JKN is a state instrument for fulfilling the public's right to health services," Filep said on Tuesday (September 1, 2026).

Furthermore, Filep stated that Committee III of the DPD RI noted that the pressure on JKN funding had become a serious concern for parliament. The House of Representatives (DPR) also reminded the BPJS deficit not to disrupt public health services, and the government needed to ensure budget support so hospitals could continue to receive timely payments.

"We appreciate the central government's stance in August 2026, stating that there were no plans to increase premiums in 2027 and that it would provide support if the National Health Insurance (JKN) experienced a deficit. However, state budget support cannot be the sole permanent solution, as it requires addressing the root causes to prevent the same issues from recurring," he said.

Filep emphasized that Committee III of the DPD RI is encouraging the government to conduct a comprehensive evaluation of the contribution structure, claim payment patterns, disease burden, service cost control, drug and medical device prices, contribution payment compliance, inactive participants, participant data validity, PBI mechanisms, and the governance and oversight of JKN funds. Participant Data Must Be Accurate

Committee III of the DPD RI also highlighted the issue of data on Contribution Assistance Recipients (PBI). According to the committee, they are still receiving complaints from poor people who have not yet received JKN coverage. Some participants may lose their membership status due to data update issues, indicating that JKN issues extend beyond financing.

Data on the poor must be updated regularly and integrated between the central and regional governments. Committee III of the DPD RI believes it is necessary to restructure the relationship between the central government, regional governments, and BPJS Kesehatan, with a clear division of responsibilities.

"The central government must ensure the sustainability of national policies and funding. Regional governments also play a role in ensuring that the poor and vulnerable receive protection and providing support for regional health services," he said.

He also emphasized the importance of ensuring certainty in claims payments to hospitals and healthcare facilities. Disruptions in claims payments can directly impact patients. Therefore, he argued, JKN reforms must ensure standard claim payment timelines, transparent verification mechanisms, and prompt and fair claim dispute resolution.

The Importance of Mitigating JKN Fraud and Reforming the BPJS Bill

Committee III of the DPD RI also urged strengthened oversight of potential fraud within the National Health Insurance (JKN) system. Allegations of fictitious claims and misuse of JKN funds must be addressed seriously, as they not only harm state finances but also reduce the system's ability to finance public services.

"In July 2026, the DPR RI also highlighted allegations of fictitious JKN claims and requested a thorough investigation. Therefore, this issue must be seriously addressed to prevent disruptions to services," he said.

Furthermore, Filep urged that the BPJS Bill undergo reform beyond mere administrative changes. In this regard, Committee III of the DPD RI believes there are at least eight main agendas, including: (1) Ensuring the sustainability of JKN financing; (2) Protecting the poor and vulnerable from the burden of healthcare costs; and (3) Clarifying the relationship and division of responsibilities between the Central Government, Regional Governments, and BPJS.

(4) Strengthening participant data validation and integration. (5) Ensuring timely payment of health facility claims. (6) Strengthening fraud prevention and eradication. (7) Increasing transparency in the management of Social Security Funds; and (8) Ensuring that JKN policies take into account the conditions and capabilities of each region.

"Committee III of the DPD RI emphasized that the sustainability of the National Health Insurance (JKN) must take financial considerations into account. However, health is a basic need and a human right that must be guaranteed by the state. Therefore, we urge the government not only to patch up the BPJS deficit but also to immediately implement structural reforms to the financing system, membership, services, governance, and central-regional relations," he said.

"JKN must be financially sustainable, as well as socially sustainable. Ultimately, BPJS's success is measured not only by its ability to pay claims or the number of registered participants, but also by ensuring the public receives adequate, prompt, and high-quality healthcare," he concluded.