Indonesia's National Health Insurance to Run Rp7 Trillion Deficit in 2024

The Indonesian Healthcare and Social Security Agency (BPJS Kesehatan) recorded revenue of Rp171.39 trillion in 2024. However, its expenses reached Rp178.53 trillion, resulting in a budget deficit of Rp7.14 trillion.

This is the first time BPJS Kesehatan has experienced a deficit since the Covid-19 pandemic.

Previously, during 2020-2023, the BPJS budget consistently showed a surplus, although the surplus trend was declining, as shown in the graph.

Along with the deficit, the total net asset value of BPJS Kesehatan also decreased from Rp56.7 trillion (2023) to Rp49.5 trillion (2024).

The government estimates that BPJS Kesehatan's assets remain secure for 2025, but challenges exist for the following year.

"The health condition of the Health Social Security Fund (DJS) assets until the end of 2025 is estimated to remain fairly controlled, although it shows a declining trend that needs to be mitigated," according to the 2026 Draft State Budget Financial Note.

"One indicator that needs attention is the increase in the claims ratio in the first half of 2025, which indicates pressure on the resilience of the Health DJS in 2026," it continues.

To address these challenges, the government is preparing several strategic steps, ranging from improved governance to financing schemes.

"A comprehensive financing scheme needs to be developed to maintain the balance of obligations between three main pillars: (1) the community/participants, (2) the central government, and (3) local governments," as quoted from the 2026 Draft State Budget Financial Note.

"Therefore, premium adjustments can be made gradually, considering the purchasing power of the community and the government's fiscal condition," it continues.