Indonesia: Millions of Poor Excluded from BPJS Health Insurance, Wealthy Included

Millions Lose Indonesian Health Insurance as Data Discrepancies Emerge

JAKARTA – A significant shakeup in Indonesia’s national health insurance program, Jaminan Kesehatan Nasional (JKN), has left millions without coverage, sparking concerns about access to vital healthcare services. As of February 1, 2026, approximately 11 million recipients of subsidized health insurance contributions (PBI-JK) have been deactivated, according to the Healthcare and Social Security Organizing Agency (BPJS Kesehatan).

The deactivation is linked to an ongoing data updating process by the Social Affairs Ministry aimed at reassessing citizens’ economic status. BPJS Kesehatan President Director Ali Ghufron Mukti stated that those deemed no longer eligible have been removed from the program, but will be replaced by other qualifying individuals, as stipulated by regulations. “More than 10 million, or about 11 million people, are considered ineligible, so their participation was deactivated,” Ghufron said on February 6, 2026.

Despite the large-scale removal of beneficiaries, Ghufron emphasized that the total number of individuals registered with BPJS Kesehatan remains stable at 96.8 million. “The PBI-JK data remains the same, only a portion is considered ineligible,” he explained.

However, the sudden change has already had severe consequences. The Indonesian Kidney Dialysis Patient Community (KPCDI) reported that at least 30 kidney failure patients were denied treatment at hospitals because their BPJS Kesehatan membership had been unexpectedly deactivated. “It’s a matter of life and death,” a KPCDI representative stated on February 4, 2026, noting that while some cases were resolved through administrative review, systemic issues within the Ministry of Social Affairs’ data verification process pose a serious threat to patients.

The situation has prompted scrutiny of the accuracy of the data used to determine eligibility. Social Affairs Minister Saifullah Yusuf revealed on Monday, February 9, 2026, that 54 million people from the lowest economic brackets (Desiles 1-5) were *not* receiving PBI-JK benefits in 2025. Conversely, 15 million individuals from wealthier segments of the population (Desiles 6-10) were incorrectly listed as recipients.

“Based on the Integrated Social Data (DTKS), You’ll see still residents in Desiles 1 and 5 who have not received PBI JK, while some in Desiles 6 to 10 are still registered,” Yusuf explained. He acknowledged that the Ministry’s data is imperfect, stating that they were only able to cross-check 12 million households in 2025, far short of the required 35 million.

Yusuf indicated that a phased transition from May 2025 to January 2026 was implemented to reduce “inclusion errors” – individuals who should not be receiving PBI-JK but are – and “exclusion errors” – those who are eligible but are not enrolled. He reported that the data accuracy has improved though some exceptions remain, including approximately 6,000 individuals with catastrophic illnesses and newborns who should be covered by the program.

The broader context of the JKN program reveals ongoing financial challenges. As of 2025, the program faced a projected deficit of 25 trillion rupiah (approximately US$1.54 billion), the largest since BPJS Kesehatan began managing JKN in 2014. This deficit has fueled debate over potential solutions, including increasing premiums and potentially reducing coverage for certain conditions.

The government is also exploring strategies to encourage wealthier citizens to transition from BPJS Kesehatan to private health insurance, a move officials believe will help ensure the financial sustainability of the national program while protecting access for low-income groups. The goal, according to officials, is to ensure health coverage for all 280 million Indonesians.

The current crisis underscores the complexities of implementing universal health coverage in a country with significant income disparities and data management challenges. The ongoing efforts to refine eligibility criteria and improve data accuracy are crucial to ensuring that the JKN program effectively serves those most in need.