Government must immediately revise Presidential Regulations no. 75 of 2019

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Timboel Siregar BPJS Watch Coordinator

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.