<![CDATA[Legal protection for participants in the National Health Insurance (JKN) scheme is a crucial aspect in ensuring that the healthcare financing system not only guarantees the programme’s sustainability but also supports the fulfilment of participants’ rights. This study aims to analyse the regulations and forms of legal protection for JKN participants, as well as to identify issues regarding their implementation and efforts to strengthen them within Indonesia’s healthcare financing system. The method employed was a literature review using a normative legal approach, involving an examination of legislation, academic articles and relevant official documents. The findings indicate that legal protection for participants encompasses certainty of benefits, the allocation of financing responsibilities, the management of social security funds, the provision of information, and mechanisms for complaints and dispute resolution. Preventive protection is realised through transparency of information, clarity of procedures, and oversight, whilst repressive protection is implemented through the handling of complaints, mediation, and dispute resolution channels in accordance with the relevant authorities’ powers. Its implementation still faces obstacles such as barriers to accessing services, issues regarding active participation, uncertainty regarding cost coverage, limited availability of services, and sub-optimal follow-up on complaints. This study concludes that strengthening legal protection requires the harmonisation of regulations and implementation, increased transparency in financing, improvements to enrolment data, and accountable oversight and complaint handling. The sustainability of financing must go hand in hand with certainty regarding benefits and equitable access to services for participants.]]>
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