IO – The Supreme Court Decision, which annuls Article 34 paragraph (1) and paragraph (2) of Presidential Regulation No. 75 of 2019, is a final and binding decision which must be obeyed by the Government. I welcome the Government’s Explanatory Holding Statement on the Supreme Court Decision canceling the increase in the contribution of National Health Insurance (JKN) for non-wage worker participants (PBPU) and non-workers (BP), specifically Point 4a, which states that the Government guarantees that the implementation of the National Health Insurance program will continue to be implemented and ensures that there will be no reduction in the health service benefits that BPJS Health participants are to receive.
With the verdict on point 4 a, JKN participants will be more assured of service, considering that there is an official who said a statement that ties this Supreme Court decision to an effort to review JKN benefits. I don’t think the Government would be wise if they’re planning to review these benefits, just because of this Supreme Court ruling.
I urge the Government to immediately create a new presidential regulation that revises presidential regulations no. 75 of 2019, specifically Article 34 paragraph (1) and (2). This revised regulation will be the legal basis for BPJS Health to change the system related to the amount of PBPU (Non-Wage Participant Participants) and BP (Non-Worker) contributions. Immediate passage of the revised Perpres is important, considering the April 2020 contribution payment process starts on April 1, 2020, which is only a few days away; further, in April, it is expected that participants are already assured of the JKN contribution payment procedure, and whether overpayments in January – March 2020 can be refunded in April and the following month.
The reason for not getting a copy of the Supreme Court’s verdict submitted by the Government to the Holding Statement should be addressed quickly by the Supreme Court, presenting the decision to the Government, so that Presidential Decree No. 75 of 2019 is promptly revised. Do not delay the recognition of the Supreme Court decision, in view of the fact the Government has been late in issuing a revision of Perpres No. 75 of 2019, so that in April 2020 independent participants (PBPU and BP) will continue to pay contributions as stipulated in Article 34 paragraph (1) and (2) of Presidential Regulation no. 75 of 2019.
Following the revision of the regulation, BPJS Health must socialize it, related to contributions that are to be paid by independent participants this April; this is of course related to overpayment from January to March 2020. There is a Complaint Desk accessed by BPJS Health to handle such JKN contribution payments.
The Parliament (DPR), especially Commission IX, must oversee and encourage the implementation of this Supreme Court decision as soon as possible, by encouraging the Government to immediately pass a new regulation that revises Perpres No. 75 of 2019. Obviously, the House of Representatives Commission IX must also continue to encourage the acceleration of the cleansing process of the data of Contribution Assistance Recipients (PBI) by the Ministry of Social Affairs, since there are still poor people who participate in Independent Class 3 and who will continue to pay Rp. 25,500 per person per month.
In addition to the above problems, I encourage the Government and BPJS Health to revise regulations related to payment of fees and the selection of health services, which must be standardized, namely, the process of payment of contributions must be combined into one KK (Family Card) and care classes must be uniform in one KK. I consider the regulations governing uniformity in the selection of treatment classes and payment of contributions as inappropriate.
The fact is that participants are considered as individuals in Article 20 paragraph (1) of the National Social Security Law, stating that the definition of a participant is “every person, whose full definition is as follows: The health insurance participant is any person who has paid contributions or those whose contributions have been paid by the Government”.
In the Law on the National Social Security System (SJSN) and Presidential Regulations no. 82 of 2018, it is mandated that all participants have the right to choose their class of treatment, and are obliged to pay their dues. This means that each participant individually has the right to choose their own nursing class without having a uniform KK. It could be that the child is registered in class 1, the father and mother in class 3. Likewise, payment of contributions should not be combined into a single payment. It could be that their children’s fees fall due on the 3rd and the parents’ on the 9th or 10th of the month.
One of these provisions stood as a further objection to the increase in JKN fees as stipulated by Presidential Regulation no. 75 of 2019 for dialysis associations, submitted for a Judicial Review to the Supreme Court.
Of course, with this Supreme Court decision, potential income from JKN social security (DJS) receipts will be reduced. However, the government can cover potential losses of contribution fees by applying Presidential Regulations no 86 2013, which imposes sanctions for declining public services to participants who are in arrears and whose contributions have not been registered with JKN. This includes companies that have not registered their workers and companies that are in arrears. The contribution can reach IDR 3.4 Trillion in one month, not to mention contributions from previous months.
Further, the cigarette tax paid to BPJS Health, following the order of Article 99 and 100 Perpres no. 82 of 2018, is not optimal. The potential could reach IDR 6.63 trillion with the calculation of IDR 177 trillion (cigarette excise tax target for 2020) x 10% (i.e. cigarette tax) x 50% x 75%. So far, it has only obtained around IDR 1.5 trillion.
The Parliament (DPR) must also oversee the implementation of Articles 99 and 100, as they are willing to encourage the revision of regulations related to the uniformity of care classes and payment of these contributions.
Hopefully the implementation of JKN will be even more successful, and it will not be negatively affected by this Supreme Court Decision. When the Government reviews JKN contributions in the future, taking its cue from this Supreme Court decision, it can pay closer attention to the community’s limited purchasing power and to regulations that potentially make it difficult for participants to pay JKN contributions.