Public Health Policy Must Not Endanger Patients
Monday, February 16, 2026
The suspension of assistance for government health insurance premiums has put some patients with chronic illnesses in danger. Such patients must be granted exemptions.
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THE health insurance governance snags have once again exposed the fragile foundations of social policy. The government intends to correct the inaccurate targeting of Premium Assistance Beneficiaries (PBI) in the Social Security Agency for Health (BPJS Kesehatan) program. That intent is valid. Subsidies must indeed be well-targeted. However, when it comes to public policy, good intentions are not enough.
The problem arises when data correction is carried out en masse without risk mitigation. On February 1, 2026, the government deactivated approximately 11 million PBI participants. Among them are kidney failure patients requiring routine dialysis, cancer patients, and patients with other chronic illnesses. This suspension was executed without adequate notice and a clear transition period. Whereas, for patients with chronic illnesses, healthcare is not an additional benefit, but a lifeline that cannot be postponed.
A meeting between the House of Representatives (DPR) and the Ministry of Health, the Ministry of Social Affairs, BPJS Kesehatan, and the Ministry of Finance has revealed the root of the turmoil. The Ministry of Social Affairs updated the PBI data by capping the quota at 96.8 million people, using welfare deciles as a screening method. However, the transparency of these indicators and the consistency of the verification process remain questionable. As is often the case, the classic issue of data governance is once again the source of the problem.
Disorganized poverty data is not a new story. Discrepancies in databases across ministries and agencies, undisciplined updates, and weak system integration make accuracy difficult to maintain. This can lead to two types of errors: first, those who are ineligible yet receive subsidies (inclusion error); and second, those who are eligible but are instead cast out of the system (exclusion error).
While it appears the government wants to reduce inclusion errors, in the context of healthcare policy, exclusion errors are far more dangerous. Ending subsidies for the wealthy is a budgetary matter; halting services for chronic patients is a matter of humanity. Therefore, the restructuring of PBI participants cannot be executed with a blanket logic because the impact varies from person to person.
Indeed, correcting PBI data is necessary. However, such a move should be accompanied by health risk mapping, a clear transition mechanism, automatic exemptions for chronic patients, and a fast and easily accessible complaint channel. Without such safeguards, a policy intended for improvement could instead create new problems.
The government is certainly obligated to maintain fiscal sustainability and prevent subsidy leakages. However, fiscal sustainability must not be pursued at the expense of guaranteed health access for the most vulnerable groups. The health insurance program was established to ensure every citizen receives adequate medical care. It is too risky to treat this program as a mere instrument for controlling state expenditures.
Good governance of BPJS Kesehatan is not measured solely by accurate figures or the magnitude of savings. The government must ensure participant safety when correcting policies. Data cleansing is an administrative task; safeguarding health services for vulnerable groups is a matter of saving lives. For that reason, access must never be severed.
