Karut Marut Disabling BPJS PBI Participants, the Government Never Wants to Learn

JAKARTA - The deactivation of BPJS Health insurance membership for the Health Insurance Contribution Assistance (PBI JK) segment has recently been widely discussed. Around 100 dialysis patients who have been receiving routine services are also affected.

Ajat, 37, is one of those affected. This Rangkasbitung, Banten resident did not carry out the blood washing procedure that he had routinely carried out, on Monday (2/2). After being traced, the health insurance in the form of BPJS PBI which had been covering him was found to be inactive, according to hospital officials.

Ajat is an ice seller whose income is uncertain, sometimes Rp. 100 thousand per day, or if it is quiet, it can only collect Rp. 20-30 thousand a day. Using BPJS PBI is the only way for Ajat to do a blood transfusion after being diagnosed with kidney failure about 11 years ago.

Ajat is not the only person whose BPJS PBI participant suddenly became inactive. There are around 11 million participants who receive PBI from the JKN program who are deactivated. As a result, hundreds of kidney failure patients from various regions are threatened with not being able to undergo dialysis.

What is regrettable, this deactivation was carried out suddenly, without prior notice. The General Chair of the Indonesian Blood Transfusion Patient Community (KPCDI) Tony Richard Samosir said, this incident showed the absurdity of the data verification system for membership of the JKN program.

"We strongly condemn the absurdity of the BPJS Health membership data verification system for Fee Assistance Recipients (PBI) which causes dozens of dialysis patients to suddenly lose access to treatment. This termination of status without notice is a form of inhumane action," said Tony, quoted from Kompas on February 8, 2026.

BPJS Kesehatan PBI is a special health insurance program for poor people and the poor who have their monthly premiums fully covered by the government. PBI participants are limited to 96.8 million residents in desil 1-5, namely the vulnerable economic group of poor to very poor.

The determination of the program is based on the National Social and Economic Single Data (DTSEN) managed by the Ministry of Social Affairs.

The deactivation of PBI is actually not the authority of BPJS Kesehatan, but is determined through the Social Minister's Decree No. 3/HUK/2026 which is valid starting 2026. Participants who do not meet the requirements, will automatically not be activated as PBI. Several factors that are the cause of their deactivation, including because the participant data is not found in DTESN. For your information, this data is dynamic and updated every three months.

Another reason could be that participants are already in desil 6-10 based on the latest verification results from the Ministry of Social Affairs.

Researcher in the Health Economics Department of the Center of Economic and Law Studies (Celios), Giovanni van Empel, said that there were many PBI participants whose status was deactivated. One important factor is that there is a transition in the social database used, from the Social Welfare Integrated Data (DTKS) to the National Socio-Economic Single Data (DTSEN).

"At this point, the negative excesses of this transition policy emerge. Because in updating data, there are participants who may be considered ineligible to receive social assistance anymore," said Giovanni on Celios' Instagram account.

On the other hand, Giovanni added, the growth of social protection budgets between 2024 to 2025 also shows a slowdown. For example, from 2021 to 2024, the average growth of social protection budgets is around seven percent, but only 1.3 percent of funds increase from 2024 to 2025.

Another factor that may not be less important is in Permensos Number 3 of 2026 which regulates matters related to the addition of the deletion or replacement of a person's PBI status.

"Although this policy or scheme for reactivating the PBI status is regulated by the same Permensos, this responsibility is entirely handed over to the affected community," he explained.

"This is where the main challenge or consequence is, because this is no longer an administrative implication but also has an impact on those who have chronic diseases," continued Giovanni.

Meanwhile, BPJS Watch Advocacy Coordinator Timboel Siregar said a similar incident had occurred last year. In July 2025, as many as 7.6 million PBI participants who also experienced the same thing and as many as 25 thousand people who reactivated. All of them also only know that their membership is inactive when they want to use BPJS.

Unfortunately, no improvements have been made by the government. The government, according to him, should have given prior notice to the public, especially those affected by the data collection of PBI membership.

Timboel added that the nonsense of the PBI participants' deactivation also occurred because the government quota remained 96.8 million people. In fact, according to the Social Health Management Report as of December 31, 2025, the number of PBI was recorded at 113.5 million or 40.2 percent of the total BPJS users. There are also PBI areas that reach 63.5 million people or 22.5 percent.

The existence of a number of PBI participants who exceeded the limit is considered normal because of the current economic situation and conditions. However, the quota of 96.8 million PBI members occurred due to budget constraints.

"Especially in the regions, the reduction in transfers to the regions from the center has an impact on the local government being forced to reduce the number of participants covered," he said.

Initially, the spirit of BPJS was to help the cost of health for citizens considering that the cost of treatment often erodes the family's finances, especially those who do not have a strong social safety net. However, the rigid quota is considered by Timboel to be deviating from the original spirit of BPJS Kesehatan.

The deactivation of membership is not carried out objectively as stipulated in Government Regulation (PP) No. 76 of 2015 concerning Changes to PP No. 101 of 2012 concerning PBI Health Insurance.

PP No. 76/2015 ensures that the deactivation does not apply to poor and poor people. In fact, the Ministry of Social Affairs and the Social Service Department deactivates unilaterally and never communicate with the affected participants.

In the rules, workers who are affected by the termination of employment and have not obtained a job for six months can be included in the PBI participant category. With a rigid quota, this is difficult to accommodate.

"The number should be made flexible. The rules are there, but they are still set at 96.8 million. The situation is many layoffs and the middle class is down. This means that the government must increase the quota and not necessarily impose it on the regions," said Timboel, quoted by BBC Indonesia on February 6, 2026.