BPJS Kesehatan Faces IDR2 Trillion Monthly Shortfall, Default Risk Looms from July 2027

BPJS Kesehatan has revealed that the financial condition of the National Health Insurance (JKN) programme is coming under pressure due to the high cost of healthcare services payable to health facilities.

President Director Prihati Pujowaskito stated that the claims ratio currently stands at 108.72%. This figure indicates that the value of claims paid by BPJS Kesehatan exceeds the revenue received from participant premiums.

Prihati noted that a deficit problem actually occurred during the 2018 to 2020 period, though finances temporarily improved during the Covid-19 pandemic as healthcare utilisation declined.

“BPJS has experience with deficits from 2018 to 2020. Then the Covid-19 pandemic brought slight efficiency. Now the claims ratio has reached 108.72%,” Prihati said during a working meeting with House of Representatives Commission IX on Wednesday (10/6/2026).

Currently, BPJS Kesehatan handles approximately two million healthcare service transactions each day. To pay for these services, it must disburse around IDR 500 billion in claims daily.

Accumulated monthly claim payments total between IDR 16 trillion and IDR 16.5 trillion, while collected premiums only amount to around IDR 14 trillion per month. Consequently, BPJS Kesehatan must shoulder a financing gap of approximately IDR 2 trillion every month.

Prihati assured that BPJS Kesehatan still has reserve funds that can be used to pay participant claims in the near term. However, he cautioned that these reserves will not be able to cover the recurring deficit without policy intervention or support from the government and stakeholders.

According to BPJS Kesehatan’s calculations, the available reserves are estimated to only sustain claim payments until early next year.

“We still have reserves for these claim payments until early next year. And we will default in July 2027 if there is no intervention or support,” Prihati said.