This study examines the integration of regional health insurance (Jamkesda) into National Health Insurance (JKN), with particular attention to local fiscal capacity and subsidized membership.
The scope covers enrolment criteria, duplicate membership, benefit differences, integration barriers, budget processes and the role of local implementers after integration. It also examines inclusion of women, people with disabilities and other vulnerable groups; identity-number requirements; and the relationship between fiscal capacity and the distribution of health workers and facilities. Findings inform national and local policy options.
Description of Assignment:
- Obtain information regarding regional fiscal capacity (provinces and districts) related to the continuation of Jamkesda contributions to BPJS Kesehatan.
- To determine the relationship between the number of PBI participants both at the national and Jamkesda levels and regional fiscal capacity.
- To determine Jamkesda benefits not included in JKN benefits according to the region’s fiscal capacity.
- To identify the factors that encourage and hinder areas that have not integrated Jamkesda into JKN.
- Get information about areas that have been integrated, but only to the extent that they register high-risk participants.
- Identifying and generating stakeholder policy formulations for regional roles in JKN, particularly related to political will, fiscal capacity, and the Jamkesda policy formulation process.
- Comparing the criteria for poor and near-poor people according to PBI standards at the national regional level, including the mechanism for determining regional PBI communities (Jamkesda)
- Identifying duplicate membership of Jamkesda and PBI participants at the national level.
- To verify how someone becomes or does not become a Jamkesda participant, especially for women and people with disabilities.
- 1To obtain information about the duties and activities of Jamkesda implementers after Jamkesda is integrated into JKN.
- Determining the budget proposal mechanism for Jamkesda to the DPRD
- Identify other Jamkesda benefits according to regional conditions.
- Develop strategies at the national and regional levels in having NIK as a requirement for integrating membership into JKN
- To obtain information about the characteristics of Jamkesda participants, especially gender, occupation, disability, and other vulnerable groups.
- Determining the relationship between the availability and equity of health workers and regional fiscal capacity
- To determine the relationship between the availability and equality of health facilities and regional fiscal capacity.
