East Java Provincial Commitment in Integrating Regional Health
Warranty Program (Jamkesda) Towards a National Health
Guarantee - Kartu Indonesia Sehat (JKN-KIS)
Muhammad Ryan Arysta
Faculty of Public Health, Universitas Airlangga, Mulyorejo, Surabaya, Indonesia
Keywords: Integrate, JKN-KIS, East Java, Java Governor Regulation, Jamkesda.
Abstract: The Minister of Home Affairs of Republic Indonesia has instructed the Regional Government to
implement all of the related programs of JKN-KIS in to the national strategy program. This study
has used the literature review method. East Java is one of the provinces in Indonesia that has been
committed to heeding to the instructions from The Minister of Home Affairs with the policy set
forth in the East Java Governor’s Regulation No. 35 of 2016 on the Mechanism of Financing and
Claiming of Health Service for Participant of Health Insurance Region. The policy set by the
governor regulates what governs every city and district in the East Java province, especially
concerning the members of “Jamkesda” who should move to the JKN program managed by BPJS
(Badan Penyelenggara Jaminan Sosial). They should give a report to the Governor through the
Public Health Office of the East Java Region. This is important for the East Java Province to prove
that they are already participating in the policy that was instructed by the Central Government.
1 INTRODUCTION
Resulting from the 58 assembly in 2005 in Geneva,
the World Health Assembly (WHA) declared that
sustainable health financing through Universal
Health Coverage (UHC) should be organised by a
social health insurance mechanism. To make this a
global commitment and basic constitution, the
government is therefore responsible for the
implementation of public health insurance through
Sistem Jaminan Sosial Nasional (SJSN). Sistem
Jaminan Sosial Nasional (SJSN) is an Indonesian
government program that has the goal to provide
protection and social welfare for all of the people of
Indonesia. Through this program, it is hoped that the
whole community will be able to fulfil the basic
need of decent living, in the case of things that result
in a loss or decrease of income due to illness or
accident. SJSN has multiple programs and
principles. SJSN has 3 principles; humanitarian,
benefits and social justice for all of the people of
Indonesia. The programs contained in the Sistem
Jaminan Sosial Nasional (SJSN) include health
insurance, accident insurance, pensions and death
insurance. The principles adopted in SJSN
implementation are the principles of mutual
cooperation, non-profit principles, the principle of
openness, prudential principles, accountability
principles, portability principles, compulsory
membership principles, trust fund principles and
fund management principles.
One of the programs being enforced by the
government is the Health Insurance Program, which
is now called the National Health Insurance-Healthy
Indonesia Card (JKN-KIS). The existence of
Jaminan Kesehatan Nasional-Kartu Indonesia Sehat
(JKN-KIS) managed by BPJS (Badan
Penyelenggara Jaminan Sosial) Health is to enforce
the regulations contained in Law Number 40
established in 2004 regarding Sistem Jaminan Sosial
Nasional (SJSN). This program has given something
new for all of the people of Indonesia about the
certainty of protection for their rights, especially in
relation to health insurance. As mentioned in Article
28 H Paragraph (3) of the 1945 Constitution, every
person has the right to social security which enables
their complete development as a dignified human
being. In accordance with SJSN Law, health
insurance is administered nationally using the
principles of social insurance and equity. The health
insurance aims to ensure that the participants benefit
from health care and protection when meeting their
basic health needs. This is in line with the 1945
Constitution, Article 34 in an effort to improve the
performance of Jaminan Kesehatan Nasional-Kartu
Indonesia Sehat (JKN-KIS). The Government, in
this case the Minister of Home Affairs of the
Republic of Indonesia, instructed the Regional
42
Arysta, M.
East Java Provincial Commitment in Integrating Regional Health Warranty Program (Jamkesda) Towards a National Health Guarantee - Kartu Indonesia Sehat (JKN-KIS).
In Proceedings of the 4th Annual Meeting of the Indonesian Health Economics Association (INAHEA 2017), pages 42-45
ISBN: 978-989-758-335-3
Copyright © 2018 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved

Government to implement all of its obligations
related to the JKN-KIS program including, among
others, instructing the Regional Government to
integrate the Jamkesda program into the JKN-KIS
program and the national strategic program.
2 METHODS
The type of this study is a literature study.
According to Notoatmojo, S. 2010: “Literature
study method is activities related to the method of
collecting data library, reading and mecatat, and
manage research materials”. The data used ranged
included textbooks, journals, scientific articles and
regulations in East Java which contain the concept
studied. Journals and scientific articles used that are
relevant to this research on integrating Jamkesda
towards a JKN KIS. In this case, what is to be
studied are the regulations and programs in the
eastern Java province that support the central
government's instruction to integrate Jamkesda in to
JKN-KIS.
3 RESULT
Since January 1, 2014, the nation of Indonesia has
entered a new era of era A National Health
Guarantee (JKN), which will gradually cover all
Indonesians and is mandatory. JKN is mandate for
Undang-undang Number 40 in 2004 that Sistem
Jaminan Sosial Nasional (SJSN), and implemented
operationally after discharge Undang-undang
Number 24 in 2011 that Badan Penyelenggara
Jaminan Sosial (BPJS). Implementation National
Health Guarantee (JKN) organized by BPJS Health
listed at Goverment Regulation and Presidencial
Decree, among others : “Peraturan Pemerintah
Nomor 101Tahun 2012, Peraturan Presiden Nomor
12 Tahu 2013 and Roadmap JKN”.
The benefits of National Health Insurance also
involve promotive, preventive, curative and
rehabilitative services including medicine and
medical consumables in accordance with any
medical needs. In order to realise the Universal
Health Coverage that started 2015, BPJS Health
activities focused on the integration of the
membership of Jamkesda in to JKN-KIS. In line
with the instructions from the Minister of Home
Affairs of the Republic of Indonesia, the Regional
Government is obliged to perform its obligations
related to the JKN-KIS program, including the
Regional Government integrating Regional Health
Insurance (Jamkesda) into the JKN-KIS program.
The law that strengthens this is stated in Article 67,
Law Number 23 from 2004 regarding the Regional
Government, as it is one of the obligations of the
Regional Head and the Deputy Head of the region
that is implementing the national strategic program.
The Government began to follow up on the
instructions by the Ministry of Home Affairs with
local government regulations or programs that
supported the integration of Jaminan Kesehatan
Daerah into Jaminan Kesehatan Nasional-Kartu
Indonesia Sehat (JKN-KIS). One of the Regional
Governments that followed up the instructions was
the East Java Province.
The East Java province followed the instructions
from the Ministry of Home Affairs by issuing the
governor’s regulation of the East Java number 35 of
2016 laws on the mechanism of financing and the
submission of health service claims for regional
health insurance participants. As for several matters
discussed in this regulation, among others in Article
3, Paragraph (1), it is explained that the district/city
government that has integrated JAMKESDA
participants into JKN programs managed by BPJS
(Kesehatan) shall report to the governor through the
provincial health office; paragraph (2) explained that
if the district/city government does not provide the
report as referred to in paragraph (1), then the
district/city government shall pay the claims of the
participants of the Jamkesda card holders who are
receiving health services in PKK.
In addition to the existing regulations, the
commitment of the program run by the East Java
provincial government is to integrating the policies
of the participants of the national health insurance
program with the data of the poorest in society as in
Penerima Bantuan Iuran (PBI).
4 DISCUSSION
Integrating Jamkesda towards JKN KIS is local
goverment register the poor and unable to BPJS
Health and pay their dues as defined in Presidential
Decree Number 111 in 2013 that health insurance.
Local governments may register a number of poor
and disadvantaged former Jamkesda participants
who are either sick or healthy according to the
adequacy of the budget and will register again the
poor and incapable as followers. The population will
benefit as regulated in the presidential regulation on
health insurance. Residents will get uniform health
services according to medical needs.
East Java Provincial Commitment in Integrating Regional Health Warranty Program (Jamkesda) Towards a National Health Guarantee -
Kartu Indonesia Sehat (JKN-KIS)
43

Current regulations in East Java are in response
to the instructions from the government on the
obligations of local governments concerning
integrating Jamkesda in to JKN in East Java. It is the
issuance of the East Java governor, regulation
number 35 in 2016 about the mechanism of
financing and the claims of health services for the
participant’s health insurance. In the regulation, it
reviews the obligations of the district or municipal
governments that have integrated JAMKESDA
members in to the JKN-KIS program.
In addition to these regulations, East Java also
executes policies in terms of the governance of the
national health insurance program participants in
relation to data collection from the poorest of society
as relates to Penerima Bantuan Iuran (PBI). This is
also the way that the East Java Province proves their
commitment to carry out central government
instructions to do with integration obligations
throughout Indonesia.
In a study conducted by M. Ali Imron Rosyadi,
his findings stated that the implementation of the
national health insurance program policy in East
Java Province is standard and that the target has
been clearly regulated according to the Decree of the
Minister of Social Service No. 146 / HUK / 2013.
This is in accordance with the stated criteria both
from the criteria of the participants and the amount
set aside for the task.
In an article on the official page of BPJS, there
are several cities or districts that have not integrated
Jamkesda in to the JKN-KIS program such as the
Trenggalek Regency, Pasuruan City, Batu Town, the
Sumenep Regency and the Sampang Regency. The
factors affecting some areas that have not integrated
Jamkesda are constraints to do with APBD. The
province of East Java remains determined to achieve
the 100% integration program by 2019
To support the implementation of the policies
that have been established by the provincial
government of East Java, the provinces have also
prepared resources for the success of this
integration. Starting from human resources and
financing from the Ministry of Social Service, the
Social Services, BPS, Health Offices and BPJS
(Kesehatan) are ready to participate in the
involvement of PBI data so that the process of the
integration with Jamkesda runs well and on target.
The Governor of East Java has a high level of
commitment when it comes to realising the success
of the JAMKESDA integration. By listing the
poorest of society into the PBI, it makes it easier for
the government to execute the central government's
instruction concerning the obligation of each region
to integrate Jamkesda into the JKN-KIS program.
The policy regarding JKN participants receiving
the PBI has been regulated in Goverment Regulation
Number 101 in 2012 that PBI and decision social
minister of Indonesia Number 146/HUK/2013 that
the determination of the criteria and data collection
of the poor and the needy. But this activity is not
implemented maximally. It is still evident that many
poor people are not included in the PBI. In 2015,
PBI 14.001.871, Jamkesda or PBI Non Kuota
707.305 and SPM 70.000.
But the head of East Java Province has a high
commitment to realize the success of this JKN, poor
people who are not included in the PBI Jamkesda in
charge of the budget, also the community has the
motivation to become participants independently.
5 CONCLUSIONS
As seen in the East Java governor's regulation
number 35 in 2016, there is substantial proof that the
East Java Provincial Government is committed to
the instructions of the Central Government in terms
of the obligations the integration of Jaminan
Kesehatan Daerah (Jamkesda) in to the Jaminan
Kesehatan Nasional – Kartu Indonesia Sehat (JKN-
KIS), managed by BPJS (Kesehatan).
REFERENCES
Aulia, Puti. Polemik Kebijakan Integrasi Jaminan
Kesehatan Daerah ke Sistim Jaminan Kesehatan
Nasional. 2014. Jurnal Kesehatan Masyarakat
Andalas. Padang.
Buku Pegangan Sosialisasi Jaminan Kesehatan Nasional
(JKN) dalam Sistem Jaminan Sosial Nasional, Menteri
Kesehatan Republik Indonesia.
Keputusan Menteri Sosial Nomor 146/HUK/2013
Mauldiana, Nuraini. Putri. Anneke. Analisis Implementasi
Integrasi Jaminan Kesehatan Daerah (JAMKESDA)
ke dalam Jaminan Kesehatan Nasional (JKN) di
Provinsi Jawa Tengah. 2016. Jurnal Kesehatan
Masyarakat Universitas Diponegoro. Semarang.
Notoatmojo, S. (2010). Metodologi Penelitian Kesehatan.
Jakarta: Rineka Cipta
Peraturan Pemerintah Nomor 101 Tahun 2012 tentang
Penerima Bantuan Iuran (PBI)
Peraturan Presiden Nomor 12 Tahun 2013 tentang
Jaminan Kesehatan
Siaran Pers BPJS Kesehatan. Integrasi Jamkesda Ke
Dalam JKN-KIS : Gotong Royong dalam Bingkai
NKRI (bpjs-kesehatan.go.id diakses pada tanggal 28
Agustus 2017 pukul 20:03)
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Undang-Undang Dasar Republik Indonesia 1945
Undang-Undang Nomor 40 Tahun 2004 tentang Sistem
Jaminan Sosial Nasional
Undang-Undang Nomor 24 Tahun 2011tentang Badan
Penyelenggara Jaminan Sosial
Undang-Undang Nomor 23 Tahun 2004 tentang
Pemerintah Daerah
Rosyadi, Ali. Implementasi Kebijakan Tatakelola Peserta
Program Jaminan Kesehatan Nasional di Jawa Timur.
2015. Dinas Kesehatan Pemprov Jawa Timur.
Surabaya.
Sriyani. Tantangan Pengintegrasian Jaminan Kesehatan
Daerah kedalam Jaminan Kesehatan Nasional untuk
Mewujudkan Cakupan Pelayanan Kesehatan
Universal. 2010. Pusdiklat Keuangan Umum. Jakarta.
East Java Provincial Commitment in Integrating Regional Health Warranty Program (Jamkesda) Towards a National Health Guarantee -
Kartu Indonesia Sehat (JKN-KIS)
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