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Antokalina Sari Verdiana
Kedeputian Bidang Aktuaria BPJS Kesehatan, Indonesia
Humanities Computer Science & IT Economics, Econometrics & Finance Education Social Sciences

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Equity of Financial Protection Under National Health Insurance: A Concentration Index Analysis in East Nusa Tenggara Muhammad Aslam Muwaffiq; Gilang Ramadhan; Antokalina Sari Verdiana; Dina Anjayani
Journal of Social Research Vol. 5 No. 5 (2026): Journal of Social Research
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/josr.v5i5.3090

Abstract

This study addresses the challenge of financial protection under Universal Health Coverage (UHC), particularly in the context of Indonesia’s National Health Insurance (JKN) program. Although JKN has expanded access to healthcare services, evidence indicates that insurance coverage does not always prevent households from experiencing Catastrophic Health Expenditure (CHE), especially in geographically disadvantaged regions such as East Nusa Tenggara (NTT). Therefore, this research aims to evaluate the equity of financial protection by examining the incidence and socioeconomic distribution of CHE among households in NTT. This study employed a quantitative approach using secondary microdata from the 2025 National Socio-Economic Survey (SUSENAS), covering 13,063 households. CHE is defined as out-of-pocket health expenditure exceeding 40% of non-food expenditure. Households are ranked using an asset-based Wealth Index, and inequality is analyzed using the Concentration Index (CI) and Concentration Curve. The results show that 16.89% of households experienced CHE, indicating substantial financial vulnerability. The findings reveal a dual inequity pattern: CHE is concentrated among the poorest households for subsidized beneficiaries (negative CI), while among non-subsidized participants, it is concentrated among the wealthiest (positive CI), reflecting different spending behaviours. In conclusion, JKN has not fully achieved equitable financial protection. Policy interventions should address both access-related costs for the poor and service quality gaps to improve system effectiveness
Employment Volatility and the Sustainability of Payroll-Based Health Insurance Contributions in Indonesia: Evidence from the February 2025 National Labor Survey Salma Khairunnisa; Antokalina Sari Verdiana
Journal of Social Research Vol. 5 No. 6 (2026): Journal of Social Research
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/josr.v5i6.3143

Abstract

This research examines the sustainability of payroll-based health insurance contributions in Indonesia using microdata from the February 2025 National Labor Force Survey (Sakernas). The analysis focuses on wage workers (pekerja penerima upah/PPU) as the main financing base of the National Health Insurance (JKN). The aim of this study is to analyze the sustainability of JKN financing, exploring factors such as income capacity, contribution coverage, job stability, employment contract structure, and job volatility, which affect the continuity of payroll-based contributions. Using cluster analysis and Principal Component Analysis (PCA), the study identifies three major labor-risk segments among PPU workers: formal and stable, semi-formal, and vulnerable or volatile. The findings show that the vulnerable or volatile group constitutes the largest share of the PPU population and exhibits the highest stopwork rate, making it the primary source of national risk to the sustainability of payroll-based contributions. In contrast, the formal and stable group presents the lowest risk, while the semi-formal group represents a smaller transitional segment with relatively high employment disruption. The sustainability of JKN financing depends not only on workers' ability to pay contributions but also on the stability of employment relationships and labor market dynamics. Policies aimed at strengthening employment continuity, reducing contract-related job disruption, and protecting high-risk sectors and regions are essential for maintaining JKN membership and contribution flows.
Co-Authors Dina Anjayani Gilang Ramadhan Muhammad Aslam Muwaffiq Salma Khairunnisa