Protection from medical bills
"JKN must serve as a guarantee so that people are not afraid to seek medical treatment," Iskandar said in a statement issued in Jakarta on Sunday, November 1.
He said an inability to pay should not leave people living in poverty anxious about seeking care or unable to obtain it. Beyond covering illness, he described JKN as protection against the financial hardship that medical expenses can bring: families may exhaust their savings, sell assets or interrupt their children's education to pay for treatment.
Central and regional governments fund JKN premiums for eligible residents. The government allocated Rp48.7 trillion in 2026 for premium assistance and measures to strengthen the JKN fund.
State obligations and access to coverage
Iskandar linked JKN coverage to Article 34, paragraph (2), of the 1945 Constitution, which directs the government to establish a social security system for all citizens and empower disadvantaged and underprivileged communities.
He also cited Presidential Instruction No. 8 of 2025, which seeks to improve health service access and quality for poor and extremely poor people. Its provisions include encouraging their enrollment in government-funded JKN premium assistance, known as PBI.
According to the State Secretariat, President Prabowo Subianto signed the instruction on March 27, 2025. Iskandar's office coordinates its implementation, and the instruction remains in force through December 31, 2029.
Employer responsibilities and inactive membership
Iskandar said businesses share responsibility for coverage: they must enroll every worker in JKN, accurately report wages and make premium payments on time. Employees of business entities and their families make up about 40 million participants and account for nearly one-third of premium contributions.
"Do not let outsourced workers and workers' family members be left out. I also urge companies to make the best possible use of their corporate social responsibility (CSR) funds to support the implementation of JKN," he said.
Across the program, government figures reported by Jakarta Globe put registered membership at about 284.5 million as of September 2026. Roughly 52 million participants were classified as inactive because they were not paying premiums. Finance Minister Suahasil Nazara said the active participation rate was 80.6 percent.
Additional funding amid a cash-flow shortfall
The appeal comes as BPJS Kesehatan, the insurer administering JKN, faces financial pressure. The Jakarta Post and Jakarta Globe reported that the government is providing an additional Rp20 trillion, about US$1.1–1.2 billion, in 2026 to bolster the insurer's finances and sustain claims payments. Suahasil said the planned disbursements were Rp10 trillion in October and another Rp10 trillion in November.
That injection is separate from the roughly Rp47 trillion budgeted for premiums covering 96.8 million government-subsidized participants.
BPJS Kesehatan president director Prihati Pujowaskito said premium receipts totaled roughly Rp118 trillion from January through September 2026, compared with about Rp132 trillion paid in healthcare benefits. The resulting cash-flow deficit was about Rp14 trillion. Officials attributed most of the gap to rising costs associated with catastrophic diseases and medical inflation.
Other measures also showed pressure on the fund. Kompas, citing Prihati, reported that the Health Social Security Fund (DJS) held net assets sufficient for about 1.48 months of claims as of mid-2026. Government Regulation No. 84 of 2015 sets the healthy threshold at 1.5 months. JKN's claims ratio reached 108.27 percent in 2025, and the report projected a risk of default in July 2027 if no intervention occurred.
Timboel Siregar, advocacy coordinator at BPJS Watch, said the Rp20 trillion injection complies with rules permitting state assistance during cash-flow difficulties but would not resolve the causes of recurring deficits.
"We welcome the government's initiative, but if asked whether this injection solves the underlying problem? Not yet. We will soon discuss the same deficit problem again," he told The Jakarta Post.
