ArticlePloS one2021
Why did informal sector workers stop paying for health insurance in Indonesia? Exploring enrollees' ability and willingness to pay.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Development of Machine Learning Models to Predict Health Insurance Claim Costs Among Older Indonesians: A Retrospective Predictive Modeling Study.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2026Article
- Local systems, local solutions: which factors drive essential medicine availability in public health facilities across Indonesia?BMJ global health · 2026Article
- Who remains uncovered? Assessing inequalities and determinants of national health insurance enrolment among informal sector workers in Kenya.Global health research and policy · 2025Article
- Payment compliance of informal sector workers in Indonesia National Health Insurance: a study on ability and willingness to pay.Health economics review · 2025Article
- Do free healthcare policies play a role in expanding national health insurance enrollment among informal sector workers? The case of the Afya Care pilot program in Kenya.BMC public health · 2025Article
- Factors associated with institutional delivery in remote areas: a cross-sectional survey in Papua Region, Indonesia.BMC pregnancy and childbirth · 2025Article
- Health insurance coverage among men and women in six countries within the Southeast Asia Region (2015-2022): a multilevel analysis of DemographicThe Lancet regional health. Southeast Asia · 2025Article
- Health insurance coverage, healthcare use, and financial protection amongst people with disabilities in Indonesia: analysis of the 2021 National Socioeconomic Survey.The Lancet regional health. Southeast Asia · 2025Article
- Response to: willingnessPublic health nutrition · 2024Article
- Impact of health benefit package policy interventions on service utilisation under government-funded health insurance in Punjab, India: analysis ofThe Lancet regional health. Southeast Asia · 2024Article
- Role of Socioeconomic Status in National Health Insurance Ownership in Indonesia's Rural Areas.Journal of research in health sciences · 2024Article
- The impact of multimorbidity among adults with cardiovascular diseases on healthcare costs in Indonesia: a multilevel analysis.BMC public health · 2024Article
- The availability of essential medicines in primary health centres in Indonesia: achievements and challenges across the archipelago.The Lancet regional health. Southeast Asia · 2024Article
- Assessing the Determinants of Compliance with Contribution Payments to the National Health Insurance Scheme among Informal Workers in Indonesia.International journal of environmental research and public health · 2023Article
- The Influence of Flexible Employment on Workers' Wellbeing: Evidence From Chinese General Social Survey.Frontiers in psychology · 2022Article
- Factors Affecting Payment Compliance of the Indonesia National Health Insurance Participants.Risk management and healthcare policy · 2022Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Indonesia faces a growing informal sector in the wake of implementing a national social health insurance system-Jaminan Kesehatan Nasional (JKN)-that supersedes the vertical programmes historically tied to informal employment. Sustainably financing coverage for informal workers requires incentivising enrolment for those never insured and recovering enrolment among those who once paid but no longer do so. This study aims to assess the ability- and willingness-to-pay of informal sector workers who have stopped paying the JKN premium for at least six months, across districts of different fiscal capacity, and explore which factors shaped their willingness and ability to pay using qualitative interviews. Surveys were conducted for 1,709 respondents in 2016, and found that informal workers' average ability and willingness to pay fell below the national health insurance scheme's premium amount, even as many currently spend more than this on healthcare costs. There were large groups for whom the costs of the premium were prohibitive (38%) or, alternatively, they were both technically willing and able to pay (25%). As all individuals in the sample had once paid for insurance, their main reasons for lapsing were based on the uncertain income of informal workers and their changing needs. The study recommends a combination of strategies of targeting of subsidies, progressive premium setting, facilitating payment collection, incentivising insurance package upgrades and socialising the benefits of health insurance in informal worker communities.
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