Main Reasons Behind BPJS Kesehatan's Premium Hike

Writer: Safrezi Fitra

Editor: Safrezi Fitra

18/9/2019, 07.19 WIB

The premium of BPJS Kesehatan is still below the ideal calculation to cover health costs.

Telaah - Asuransi Kesehatan
Jakub Jirsak/123rf

The government has confirmed the premium of National Health Insurance (JKN) managed by the Health Care and Social Security Agency (BPJS Kesehatan) will increase next year. It is done to save BPJS Kesehatan’s finances that are always in deficit. This way, the National Social Security System (SJSN) can continue to run.

Presidential Chief of Staff Moeldoko also said that there would be an increase in the BPJS Kesehatan’s premium. This increase is implemented even though the House of Representatives (DPR) rejected some of the government’s proposals. He ensured that President Joko “Jokowi” Widodo will immediately sign the regulation related to the premium increase. “So it must increase,” he said in Jakarta, Wednesday (9/4).

Finance Ministry proposes a 100 percent increase to Rp 160,000 from Rp 80,000 for the JKN class I independent participants, a 100 percent increase to Rp 110,000 from Rp 55,000 for the class II participants, and 65 percent increase to Rp 42,000 from Rp 25,000 for the class III participants.

The government also proposes a wage limit imposed for calculation of premium for wage recipient (PPU) from business entities and the government, with a fixed percentage of five percent of wages. The wage limit for private employees has been increased from Rp 8 million to Rp 12 million and is proposed to take effect in January 2020.

While the wage limit for government employees is proposed to be added with performance benefits from the previous, which only covers basic salaries and family benefits, the increase for BPJS Kesehatan's premium payments is advised to take effect from October 2019. While for premium assistance (PBI) participants, the premium is proposed to increase from Rp 23,000 to Rp 42,000 and it is recommended to take effect starting August 2019.

The planned increase is higher than the recommendation from the National Social Security Board (DJSN). Based on DJSN calculations, the BPJS deficit problem could be overcome with a 50 percent increase in class I premium, 47 percent in class II premium, and 65 percent in class III premium. According to the Finance Ministry calculations, this increase is not only to cover the deficit, but also create a surplus to finance BPJS Kesehatan starting next year.

BPJS Kesehatan deficit always goes up, even though it has been helped by additional funding from the government. In 2014, the amount of the deficit was only Rp 1.9 trillion, and then it multiplied many times to reach Rp 19.4 trillion last year.

According to BPJS Kesehatan President Director Fachmi Idris, three options could be done: adjusting the amount of premium, rearranging the benefits, and injecting additional funds. From the government, BPJS Kesehatan received Rp 5 trillion in 2016, Rp 6.8 trillion in 2016, Rp 3.6 trillion in 2017, and Rp 10.25 trillion last year.

Budget constraints prevent the government from continuing to provide funds. Hence, another option was made by increasing the JKN's premium. If the JKN's premium is not raised, the Finance Ministry estimates that BPJS Kesehatan deficit could reach Rp 32 trillion this year. The value will continue to grow to Rp 44 trillion next year and Rp 56 trillion in 2021.

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