Why BPJS Kesehatan is Planning to Raise Health Insurance Rates

3 hours ago 1

September 15, 2025 | 10:55 am

Illustration of BPJS Kesehatan. TEMPO/Tony Hartawan

TEMPO.CO, Jakarta - Before being removed as Indonesian Finance Minister, Sri Mulyani Indrawati had conveyed a plan to adjust the BPJS Kesehatan health insurance rates to maintain the sustainability of the National Health Insurance Program (JKN). During a working meeting with the Budget Agency (Banggar) of the Indonesian House of Representatives (DPR) in Jakarta on Thursday, Sri Mulyani explained that the sustainability of the JKN program heavily depends on the extent of benefits that can be provided to all participants.

"If the benefits provided to participants increase, then the required costs will inevitably also rise," said Sri Mulyani, as quoted from Antaranews on August 21, 2025.

The adjustment of BPJS Kesehatan insurance premiums is expected to increase the number of Beneficiary Assistance Recipients (PBI), which are groups of people subsidized by the government. The government also endeavors to ensure that self-paying participants, especially Non-Wage Recipients (PBPU), can still join the JKN program at an affordable price.

According to Sri Mulyani, although the self-paying premium for PBPU should be Rp43,000, participants are only charged Rp35,000. The Rp7,000 difference will be subsidized by the government to ensure that the amount paid by participants remains affordable.

Regarding the final decision on adjusting BPJS Kesehatan insurance premiums, Sri Mulyani explained that further discussions will be held among the government, DPR, Health Minister, and BPJS Health.

In the Draft State Revenue and Expenditure Budget (RAPBN) 2026, the government has allocated a budget of Rp244 trillion for the health sector, with Rp123.2 trillion of this amount allocated for public health services. The majority of this budget, approximately Rp69 trillion, will be used for premium assistance to 96.8 million PBI and premiums for PBPU/Non-Wage Workers (BP) amounting to 49.6 million people.

The adjustment of BPJS Kesehatan insurance premiums is also included in Book II of the Financial Note and RAPBN for the 2026 Fiscal Year. In this review, the government acknowledges various challenges in implementing social insurance programs, particularly related to participants' compliance in paying premiums and the increasing burden of claims to be covered by BPJS Kesehatan.

The government suggests that the financing scheme for the JKN program be comprehensively and equitably designed to avoid burdening any party, including participants, the central government, and regional governments.

Furthermore, the government proposes that the adjustment of premium rates be carried out gradually, while still considering the purchasing power of the community and the fiscal condition of the government. The impact of this premium adjustment will also take into account several main factors, including adjusting premium assistance for PBI participants, increasing the government's contribution to PBPU/BP Class III participants, and the burden borne by the government as the employer for Civil Servant PPU (PPU Penyelenggara Negara).

However, DPR has not yet approved the government's plan to raise BPJS Kesehatan insurance premiums in 2026. The plan was previously outlined in Book II of the Financial Notes RAPBN 2026.

"Until now, the DPR RI's Commission IX has not yet approved the plan to increase the premiums," said Commission IX member of DPR Irma Suryani Chaniago in a written statement quoted on Thursday, August 28, 2025.

She believes that the plan to increase the premiums needs to be further evaluated. Especially in the context of the national economic conditions and the protection of low-income communities.

Annisa Febiola and Hanin Marwah contributed to the writing of this article.

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