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October 20, 2025

Iuran BPJS Kesehatan Naik Tidak Bisa Atasi Defisit

Iuran BPJS Kesehatan Naik Tidak Bisa Atasi Defisit
Hery Susanto Koordinator Nasional Masyarakat Peduli BPJS
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Jakarta,- Kenaikan Iuran BPJS Kesehatan sebagaimana tertuang dalam Peraturan Presiden (Perpres) Nomor 75 Tahun 2019 tentang Perubahan atas Perpres Nomor 82 Tahun 2018 tentang Jaminan Kesehatan, dinilai tidak akan atasi defisit BPJS Kesehatan. Demikian disampaikan oleh Hery Susanto Koordinator Nasional Masyarakat Peduli Badan Penyelenggara Jaminan Sosial (KORNAS MP BPJS) melalui siaran pers di Jakarta (6/11).

Perpres tersebut mengatur kenaikan iuran BPJS Kesehatan kelas 3 menjadi Rp. 42.000/bulan, kelas 2 menjadi Rp. 110.000/bulan dan kelas 1 menjadi Rp. 160.000/bulan. Iuran baru BPJS kesehatan akan berlaku per Januari 2020.

Menurut Hery Susanto, Perpres tersebut hanya bersifat tambal sulam demi membayar hutang BPJS Kesehatan atas klaim dari banyak faskes dan RS yang mencapai hingga 31 triliun rupiah pada tahun 2019 ini.

“Perpres tersebut hanya bisa untuk sementara waktu atasi pembayaran hutang BPJS Kesehatan, paling tidak hingga akhir Desember 2019 ini sebesar Rp 15 triliun dari iuran segmen penerima bantuan iuran (PBI) melalui APBN dan APBD. Selebihnya berharap dari efek kenaikan iuran peserta mandiri tiap kelasnya,” kata Hery Susanto.

Menurut Hery Susanto, masalah defisit BPJS kesehatan harus dilakukan secara holistik, tidak bisa tambal sulam. Kebijakan pemerintah saat ini masih tambal sulam, atasi defisit dengan cara menaikkan iuran JKN hanya akan menambah beban warga.

“Defisit itu terjadi karena design JKN yang sudah keliru sejak awal pengelolaan JKN oleh BPJS Kesehatan,” kata Hery Susanto.

Hery Susanto menjelaskan langkah atasi defisit BPJS Kesehatan mestinya dilakukan langkah pertama, harus ada pembenahan pola kebijakan distribusi kapitasi peserta BPJS kesehatan. Sebab masih dominan dimonopoli oleh faskes I pemerintah.

“Distribusi kapitasi peserta PBI BPJS Kesehatan harus proporsional dan berkeadilan. Distribusi kapitasi peserta BPJS kesehatan PBI rawan dikorupsi,” ucap Hery Susanto.

Kedua, perbaikan pola pembayaran klaim BPJS kesehatan yang transparan dan akuntabel. Pola INA-CBG’s mesti diperbarui. Untuk hindari klaim fiktif.

Ketiga, perlu dilakukan data cleansing peserta PBI BPJS kesehatan yang merupakan warga miskin dibayar melalui APBN dan APBD. Peserta PBI banyak yang tidak tepat sasaran. “PBI ini peserta BPJS kesehatan yang paling banyak gunakan klaim. Peserta PBI APBN Jumlah nya 96.7 juta orang dan PBI APBD 31 juta orang,” jelas Hery Susanto.

Keempat, hapus sistem kelas BPJS kesehatan. Cukup kelas standar saja tidak ada kelas 1, 2 dan 3. Ini sesuai dengan prinsip keadilan. Jika ingin naik layanan kelas harus top up sendiri.

Kenaikan iuran BPJS Kesehatan tidak berefek atasi defisit justeru akan menambah peserta menunggak iuran. Ini akan menambah rumit JKN. Sanksi denda pelayanan sudah berlaku sebelum iuran naik. Tapi sanksi administrasi tidak mendapatkan pelayanan publik itu masih jauh panggang dari api. Perangkat hukum nya belum jelas dan akan mendapat protes keras warga.

“Sikap warga saat ini nampaknya akan banyak gerakan turun kelas ke kelas 3. Bagi yang mampu, bagi yang tidak mampu ya akan menambah jumlah peserta menunggak saja,” pungkasnya.

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