Evaluasi Program Jaminan Kesehatan Nasional (JKN) Bagi Masyarakat Kurang Mampu

Evaluation of the National Health Insurance (JKN) Program for Underprivileged Communities

Abstract

Program Jaminan Kesehatan Nasional (JKN) merupakan kebijakan strategis pemerintah Indonesia yang bertujuan memberikan perlindungan kesehatan menyeluruh bagi seluruh lapisan masyarakat, termasuk kelompok kurang mampu melalui skema Penerima Bantuan Iuran (PBI). Penelitian ini bertujuan untuk mengevaluasi pelaksanaan program JKN bagi masyarakat kurang mampu menggunakan pendekatan evaluasi kebijakan publik yang dikemukakan oleh James E. Anderson. Metode yang digunakan adalah literature review terhadap berbagai jurnal ilmiah, dokumen kebijakan, dan laporan lembaga terkait. Hasil evaluasi menunjukkan bahwa meskipun program JKN telah berhasil memperluas akses layanan kesehatan dan menekan beban pengeluaran kesehatan rumah tangga hingga 97,8%, pelaksanaannya masih menghadapi berbagai hambatan. Dari sisi implementasi, terdapat ketidakselarasan penerapan regulasi di tingkat daerah dan lemahnya sosialisasi program. Dari sisi kinerja, kesenjangan kualitas layanan antara wilayah perkotaan dan perdesaan masih cukup signifikan. Dari sisi efisiensi, permasalahan meliputi ketidaksesuaian tarif INA-CBGs, rendahnya kepatuhan peserta mandiri dalam membayar iuran, serta lemahnya koordinasi antarlembaga. Evaluasi berkelanjutan dan perbaikan kebijakan yang mendalam diperlukan agar JKN dapat semakin efektif berkontribusi pada pencapaian agenda SDGs, khususnya dalam pengentasan kemiskinan dan pemerataan akses kesehatan.

The National Health Insurance (JKN) program is a strategic policy of the Indonesian government aimed at providing comprehensive health protection for all levels of society, including underprivileged groups through the Premium Assistance Recipient (PBI) scheme. This study aims to evaluate the implementation of the JKN program for underprivileged communities using the public policy evaluation approach proposed by James E. Anderson. The method used was a literature review of various scientific journals, policy documents, and reports from related institutions. The evaluation results indicate that although the JKN program has succeeded in expanding access to health services and reducing household health expenditures by up to 97.8%, its implementation still faces various obstacles. In terms of implementation, there is a lack of alignment in the application of regulations at the regional level and weak program socialization. In terms of performance, the gap in service quality between urban and rural areas remains quite significant. In terms of efficiency, problems include inconsistencies in INA-CBGs tariffs, low compliance of independent participants in paying contributions, and weak coordination between institutions. Continuous evaluation and in-depth policy improvements are needed so that JKN can increasingly effectively contribute to the achievement of the SDGs agenda, particularly in poverty alleviation and equitable access to health.