JAKARTA - President Director (Director) of BPJS Kesehatan Ali Ghufron Mukti responded to as many as 7.3 million participants who received National Health Insurance Assistance (PBI) who were disabled due to the transition to National Sole Social Economic Data (DTSEN).
Ghufron explained that the decision was based on the Decree (SK) of the Minister of Social Affairs Number 80 of 2025 and Presidential Instruction (Inpres) Number 4 of 2025 concerning National Sole Social and Economic Data (DTSEN).
"Referring to the regulation, starting in May 2025 the determination of PBI participants will use the DTSEN database. However, those who were deactivated could be active again if they contacted or reported to the local social service," he said when met after the signing ceremony with the Food and Drug Supervisory Agency (BPOM) in Jakarta, Tuesday, June 24, was confiscated by Antara.
He explained, there are three conditions for PBI JKN participants to be able to return to being active and regain facilities at BPJS Kesehatan, first, namely being disabled in May 2025.
"Second, after being verified (local local governments/Ministry of Social Affairs) it is true that they are poor or almost poor, thirdly, if the person concerned has a chronic disease or the term emergency (emergency) which requires immediate treatment, it can be immediately activated," he said.
However, according to him, if the participants do not meet the three requirements, they are not considered to be included in PBI JKN, so that the BPJS Health contribution scheme can be financed by the local government or paid independently.
"So, that doesn't mean then you can't access that way. So far, many people have made mistakes about the inactive meaning. Inactively, he is in arrears to pay, issuance because he doesn't pay, or doesn't pay, but in the local government there is a priority Universal Health Coverage (UHC), so it doesn't mean that if you don't get access to the hospital, participants can go there (the local government) and continue to be reactivated immediately," he said.
Ghufron also stated that the number of inactive participants would not affect the total allocation of PBI JKN from the state, which was around Rp. 96.8 million.
"It was replaced with a new one. The person can change it, but the number is still fixed, even though there is a risk for active participants because they do not know," he said.
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For this reason, Ghufron conveyed the importance of active JKN participants continuing to check participation in BPJS Kesehatan through the application, to obtain the latest information and reduce the risk of late paying or being disabled.
Previously, Minister of Social Affairs (Mensos) Saifullah Yusuf stated that 7.39 million PBI JKN participants were disabled because they were not registered in DTSEN and were considered prosperous.
The recipient of PBI JKN assistance has an allocation of around Rp. 96.8 million, originating from proposals from regents and mayors throughout Indonesia. After the data matching, as many as 7.3 million participants were disabled because they were not registered with DTSEN and were considered prosperous," said the Minister of Social Affairs.
The Minister of Social Affairs emphasized that the national quota for PBI JKN was not reduced, because the disabled participants would be immediately replaced by underprivileged people who were recorded in the DTSEN database.
"Changes for participants can come from Desil 1 to Desil 5. We will coordinate with BPS. Including vulnerable families will still be assisted," said Saifullah Yusuf.
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