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BPJS Kesehatan urges premium hike to dig itself out of deficit
The national health insurer has accumulated a deficit of more than US$800 million so far this year as claims payments for health facilities vastly exceed revenue.
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An employee helps a customer on May 14, 2024, at the South Jakarta branch of the Healthcare and Social Security Agency (BPJS Kesehatan). (Antara/Akbar Nugroho Gumay)
T
he Healthcare and Social Security Agency (BPJS Kesehatan), which operates the National Health Insurance (JKN), is urging a hike to its premiums to ensure the program’s sustainability in light of a record shortfall.
The proposed hike is expected to be discussed with the government, which must set new membership fees by July 1 next year as part of a plan to consolidate the three existing categories into a single, standardized plan.
Mahlil Ruby, planning and development director at BPJS Kesehatan, said on Monday that the JKN recorded a Rp 9.2 trillion (US$585 million) deficit last year because claims payments for health facilities outpaced revenue collection.
As of October, the program had earned Rp 133.5 trillion in revenue but incurred Rp 146.3 trillion in expenses, leaving a deficit of Rp 12.8 trillion for the first ten months of this year.
The figure marks the largest deficit since the agency was established, and poses a precarious outlook if the government does not intervene.
“There is a risk that BPJS Kesehatan may be unable to cover claims as soon as August 2025,” Mahlil said.
Contributing factors to the agency’s financial strain included many members not paying their premiums, insignificant hikes to wages that limited revenue growth and substantial unpaid debt from regional administrations, he said.
