Indonesia’s healthcare agency forecasts historic deficit of $1.21 billion for National Health Insurance program in 2024

BPJS Kesehatan has around 267.3 million registered users, which is almost 95.75 per cent of the country’s population, at the end of the previous year.

In a significant revelation, Indonesia’s healthcare agency has projected a historic deficit for the current year. For the National Health Insurance program this year, the Healthcare and Social Security Agency (BPJS Kesehatan) has projected a record deficit.

The analysts suggested that the agency should start working on an alleviation strategy, that would help in raising fees, requesting cash injections from the government, or reducing benefits for members. The gap projected would be almost Rp 18.9 trillion (US$1.21 billion) between its fee revenue and benefit payouts, marking the largest shortfall that the agency would have experienced since 2014.

BPJS Kesehatan has around 267.3 million registered users, which is almost 95.75 per cent of the country’s population, at the end of the previous year. However, according to Abdul Kadir, the chairman of BPJS Kesehatan’s supervisory board, almost 53 million of the registered people did not regularly contribute financially. The chairman of BPJS Kesehatan’s supervisory board also noted that the expenses to cover the claims from the health facilities still exceeded the revenue that the agency could collect in a single year from the members. During an event memorializing the 10th anniversary of the program, Abdul Kadir said, “We predict a deficit of around Rp 18.9 trillion this year. That means BPJS Kesehatan’s assets will be eroded, which may fail to pay for treatment in the future. All stakeholders need to think about this problem and determine how to ensure the resiliency of BPJS Kesehatan.”

BPJS Kesehatan recorded at least Rp 151.4 trillion in membership revenue, last year. It marked an increase of around 5 per cent increase over the earlier year. On the other hand, there was an increase of more than 40 per cent to Rp 158.8 trillion in the expense of the public health care provider in covering claims. For the year 2024, the agency forecasted membership revenue is Rp 157.8 trillion, and around Rp 176.8 trillion in claims expenses.

According to the president director of BPJS Kesehatan, Ali Ghufron Mukti, the agency had Rp 57.76 trillion in assets at the end of the previous year, an amount that could cover member’s claims without additional income for 4.4 months, which is more than the legally required 1.5 months. As quoted by Bisnis, he also stated that they deliberately increased the projection for health benefit expenses, in line with members’ increased confidence in BPJS Kesehatan services. People who never used BPJS were now using it. Before the coronavirus pandemic, negative assets were reported by BPJS Kesehatan following years of deficits. But eventually, the assets turned positive during the global health crisis because many people were a bit reluctant to visit hospitals for non-COVID issues. Simultaneously the membership fees of the BPJS were increased by the government.