Barriers to Expanding the National Health Insurance Membership in Indonesia: Who Should the Target?

Background:The Indonesian government initiated National Health Insurance (NHI) to reduce health service barriers. The
study aimed to analyze specific targets for expanding the NHI’s membership in Indonesia. Methods: The study population
was all populations in Indonesia. Meanwhile, the study involved a 47 644 weighted sample. The analyzed variables included
NHI’s membership, residence, age, gender, education, employment, marital status, and wealth. The study employed binary
logistic regression in the final step. Results: The urban population was 0.608 times less likely than the rural population to
become a non-member of NHI. Aging younger was one of the barriers to becoming an NHI member, and the male gender
is one of the barriers to becoming an NHI member. Meanwhile, the lower the education level, the greater the obstacles
to becoming an NHI member in Indonesia. Besides, the unemployed population was 1.002 more likely than the employed
population to become a non-member of NHI. The result shows that never married or married have a higher chance of
becoming a non-member of NHI. Finally, all wealth status categories are more likely to become barriers to the most
prosperous population becoming an NHI member. Conclusions: The study concluded that 7 population characteristics
become specific targets for expanding NHI membership in Indonesia. The 7 characteristics are the population who live in rural areas, are young, male, poor education, unemployed, never married or married, and poor