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House rejects JKN health insurance hike for poor

Healthcare customers: People wait in the Health Care and Social Security Agency (BPJS Kesehatan) office in Matraman, Central Jakarta, on Wednesday

Gemma Holliani Cahya (The Jakarta Post)
Jakarta
Fri, November 8, 2019

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House rejects JKN health insurance hike for poor

H

ealthcare customers: People wait in the Health Care and Social Security Agency (BPJS Kesehatan) office in Matraman, Central Jakarta, on Wednesday. The agency estimates that 30 percent of its members will downgrade their membership status in response to the government plan to increase premiums next year.(JP/Dhoni Setiawan)

Members of the House of Representatives are objecting to an increase in national health insurance (JKN) premiums, especially for participants in the third class, the lowest class in the scheme.

On Wednesday night, the House held a hearing with the insurer, the Health Care and Social Security Agency (BPJS Kesehatan), and the Health Ministry to discuss a recent presidential decision to increase the premiums.

Dewi Asmara, a member of Commission IX overseeing health and manpower from the Golkar Party, said that they disagreed with the government's decision to keep increasing the JKN premiums.

Before issuing the regulation, there was a meeting between BPJS Kesehatan, the Finance Ministry, the Health Ministry and House commissions IX and XI overseeing finance to discuss the premium increase.

Dewi said at that during the meeting the House members had rejected the idea of increasing the insurance premiums of the third-class participants and hikes in the premiums of those from the informal sectors.

"At that time we urged the government to find another way to solve the [JKN] deficit problem, but we see that the new presidential regulation did not respect our recommendations at the meeting," Dewi said.

The insurance members and observers protested against the new presidential regulation (Perpres) on health care security issued at the end of October. The regulation has stipulated increases of about 100 percent for the premiums of all three classes of JKN participants.

The JKN premiums for the first-class service are increasing from Rp 80,000 (US$5.72) to Rp 160,000 per month, second-class premiums are more than doubling to Rp 110,000, and the premiums for third-class, which includes coverage for the fully subsidized poor citizens in the country, is increasing from Rp 25,500 to Rp 42,000. The new premiums will be effective in January.

Observers have warned that the new rates will force many people to quit the insurance scheme or else downgrade their coverage and crowd into the lower classes, the facilities of which are still limited.

Dewi also said that during the hearing with the ministries and BPJS Kesehatan, the House members had expressed their objections to the rising JKN premiums and also criticized irregularities in the JKN participants' data, especially around the numbers of contribution-assisted recipients (PBI) who are fully subsidized by the government.

There were reports that the data included people who owned businesses and who were not eligible to receive government for the JKN.

Nur Yasin, a National Awakening Party (PKB) lawmaker, said that even he and his family were listed as participants of the PBI as low-income participants.

While some who are able to pay for the first-class service were listed as PBI participants, many poor people are not registered.

"More than 20 to 30 percent of PBI participants missed its target; there are poor people who are still not targeted," said Dewi Aryani, a lawmaker from the Indonesian Democratic Party of Struggle (PDI-P).

Saleh Partaonan Daulay from the National Mandate Party (PAN) said he regretted how the government decided to increase the premiums without fixing the participants' data.

"The government cannot find ways and subsidies to solve the issue so it decided to sacrifice people," he said. "So when another problem occurs in the future will there be another rise in premiums? We can't do that."

Responding to the lawmakers during Wednesday's hearing, BPJS Kesehatan director Fachmi Idris reiterated that BPJS had a massive deficit that required emergency measures.

Fachmi said there were three options for solving the issues surrounding the financing of the insurance scheme, namely the adjustment of the premiums based on actuarial value, the adjustment of the benefits that will be given out and providing additional funds.

"If we don't make any fundamental changes by the end of 2024 we will have a deficit of Rp 77 trillion," Fachmi said.

Newly installed Health Minister Terawan Agus Putranto gave assurances that he would accept all the input from the House and would discuss it further.

Terawan also admitted that most of the problems that BPJS Kesehatan faced were in the data. He promised that the ministry would assemble a special team to study the massive deficit in the JKN.

"Our team will invite experts from universities to help us in this study. We will synchronize our data and findings with experts from the universities," the minister said.

Terawan said he had also talked to State Secretary Pratikno about a plan to provide more government subsidies for third-class recipients.

“We will fight for [the subsidies]. We will also consider the possibility that a large number of participants will migrate to lower classes of service,” he said.

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