LEGAL REVIEW OF LOCAL GOVERNMENT PRIMARY HEALTHCARE FACILITY SELECTION FOR JKN PBPU PEMDA PARTICIPANTS
Keywords:
Budget sustainability, JKN, Legal certainty, PBPU Pemda, Regulatory harmonization.Abstract
Indonesia's National Health Insurance (JKN) program requires coordination between central and local governments, particularly in financing vulnerable residents through the locally funded PBPU Pemda scheme. This article examines tensions between regional head regulations directing participants to public community health centers (Puskesmas) as their first-level healthcare facilities (FKTP) and Article 6A of Presidential Regulation No. 59 of 2024, which protects participants' freedom of choice. Using normative legal research with statutory and conceptual approaches, the study assesses regulatory hierarchy, administrative discretion, fiscal sustainability, and principles of good governance. The findings indicate that conflicting local provisions arise partly from the absence of specific national operational guidance addressing regional financing responsibilities. Directing enrolment toward Puskesmas may support capitation-based funding, preventive programs, and service supervision, but compulsory placement risks violating superior regulations. Harmonized implementing rules are therefore needed to establish lawful, proportionate enrolment arrangements that safeguard public health financing without undermining participants' rights to choose accessible and appropriate healthcare facilities.
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References
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