58 million inactive participants, BPJS continues to strengthen JKN data validity

Jakarta (ANTARA) - BPJS Kesehatan states that the number of inactive National Health Insurance (JKN) participants currently stands at 58.32 million, caused by various factors, making the strengthening of participant data validity one of the aspects continuously being optimised.

“Of that number, 13.48 million individuals are inactive due to overdue premiums, while 44.84 million come from the deactivation of Premium Assistance Recipients (PBI) and participants funded by local governments. Data updates over the past two months have also led to the deactivation of around 11 million participants, some of whom have transitioned to independent participants,” said BPJS Kesehatan Chief Executive Prihati Pujowaskito during a Hearing with Commission IX of the House of Representatives (DPR RI) in Jakarta on Wednesday.

Pujo explained that low compliance with premium payments particularly occurs among Non-Wage Workers (PBPU) or the informal sector due to low willingness to pay and unstable financial capacity.

“In addition, the reduction in transfer funds to regions also has the potential to affect the fiscal capacity of local governments in fulfilling their JKN premium payment obligations,” he stated.

“Nevertheless, the resilience of the Social Security Fund (DJS) remains above 100 percent. However, the claims ratio since 2023 has reached 104.72 percent, indicating increasing financial pressure. This condition is driving BPJS Kesehatan to strengthen premium collection and participant data validity as the foundation for the programme’s sustainability,” he elaborated.

He also added several current issues faced by BPJS Kesehatan, such as the deactivation of APBN-funded PBI in June 2025 and February-March 2026, which will impact risk profile shifts and a decline in active participants.

“Therefore, we continue to support ground-checking conducted by the Ministry of Social Affairs, the Central Bureau of Statistics, and the Coordinating Ministry for Human Development and Culture (Kemenko PMK) regarding the National Single Social-Economic Data,” said Pujo.

In addition, BPJS Kesehatan is currently undergoing service transformation in the form of changing the INA CBGs payment system to iDRG, as well as implementing referrals based on service capabilities and Standard Inpatient Class (KRIS).

“Currently, the write-off of overdue premiums is also in process, supported by a Presidential Regulation (Perpres) being prepared jointly with Kemenko PMK,” said Pujo.