Legal Review of KRIS Implementation under Presidential Decree No. 59 of 2024 (amending Presidential Decree No. 82 of 2018 on Health Insurance) and Law No. 40 of 2004 on the National Social Security System
DOI:
https://doi.org/10.15575/jis.v6i3.56032Keywords:
National Social Security System (SJSN), Policy Implementation, Presidential Regulation 59/2024, Standard Inpatient Care Class (KRIS)Abstract
This study stems from concerns regarding normative changes to inpatient care classifications introduced by Presidential Regulation No. 59 of 2024—which reforms Presidential Regulation No. 82/2018—within the framework of Law No. 40 of 2004 on the National Social Security System (SJSN). It focuses on assessing whether the Standard Inpatient Class (KRIS) aligns, both legally and operationally, with the principles of equity and sustainability underpinning the National Health Insurance (JKN) scheme. The research aims to (1) map and interpret the KRIS regulations set forth in Presidential Regulation 59/2024 and (2) evaluate the alignment of KRIS implementation with SJSN principles. A normative legal research (doctrinal legal research) methodology was employed, utilizing statutory, legal-hermeneutic, and vertical-horizontal harmonization analysis approaches, alongside qualitative content analysis of legal and policy documents (2015–2025). The findings indicate that, doctrinally, Presidential Regulation 59/2024 establishes a legal framework coherent with SJSN objectives; however, substantive alignment depends on the finalization of implementing regulations, adjustments to tariffs and premiums, and hospital operational readiness. Data reveal inconsistencies in meeting the 12 KRIS criteria and a potential for service fragmentation arising from "top-up" mechanisms. The study concludes that while KRIS supports equity *de jure*, its achievement remains conditional *de facto*. Consequently, it recommends finalizing derivative regulations, adjusting financing structures, providing transition support for regional hospitals, and adopting an H-E-I (Law–Equity–Implementation) evaluative framework alongside further empirical study.
References
Ambas, J., Rahman, E., Siswati, S., Tahir, A., Amin, A. N., Laksono, R. D., & Finasim. (2025). Manajemen Pelayanan Sektor Publik (Teori dan Praktek Layanan Publik di Rumah Sakit) [Public Sector Service Management (Theory and Practice of Public Services in Hospitals)]. MEGA PRESS NUSANTARA.
Aminasya, N., & Suriani, A. (2024). Transformasi Sistem Kelas BPJS dan Implikasinya Terhadap Akses dan Keadilanlayanan Kesehatan di Indonesia [The Transformation of the BPJS Class System and Its Implications for Access and Equity in Health Services in Indonesia]. Central Publisher, 2, 2048–2054. https://doi.org/https://doi.org/10.60145/jcp.v3i5.651 [In Indonesian]
Aryami, A. D. (2024). Kelas Rawat Inap Standar Perpres No. 59 Tahun 2024. Webinar USAID [Standard Inpatient Class Presidential Decree No. 59 of 2024. USAID Webinar]. In BPJS Kesehatan. https://thinkwell.global/wp-content/uploads/2024/07/4.-Webinar-KRIS-USAID_11-Juli-2024-Ari-Dwi-Aryani.pdf?
Aziza, S. N., Ayunina, Q., Harsono, R. A., No, A. P., JKN, R. G., & Desember. (2024). Analisis Perpres No. 59 Tahun 2004 Tentang Pemberlakuan Kelas Rawat Inap Standar (KRIS) JKN [Analysis of Presidential Decree No. 59 of 2004 concerning the Implementation of the JKN Standard Inpatient Class (KRIS)]. https://www.researchgate.net/publication/387297922_Analisis_Perpres_No_59_Tahun_2024_tentang_Pemberlakuan_Kelas_Rawat_Inap_Standar_KRIS_JKN
CNN, I. (2025). Menkes Usul Penerapan Kris BPJS Mundur ke Desember 2025 [The Minister of Health proposed postponing the implementation of the BPJS Ketenagakerjaan program to December 2025.]. https://www.cnnindonesia.com/ekonomi/20250526163232-78-1233373/menkes-usul-penerapan-kris-bpjs-mundur-ke-desember-2025
Dewi, R. D. L. P., Siswanto, A., Lestari, W., Ratnawita, R., & Judijanto, L. (2024). Metodologi Penelitian Perilaku Organisasi: Panduan dan Implementasi [Organizational Behavior Research Methodology: Guide and Implementation]. PT. Green Pustaka Indonesia.
Diantha, I. M. P. (2016). Metodologi Penelitian Hukum Normatif dalam Justifikasi Teori Hukum [Normative Legal Research Methodology in Justifying Legal Theory]. Prenada Media Group.
DJSN, P. R. (2024). Perpres No 59 tahun 2024 Tentang Perubahan Ketiga atas Perpres Nomor 82 tahun 2018 Tentang Jaminan Kesehatan [Presidential Decree No. 59 of 2024 concerning the Third Amendment to Presidential Decree No. 82 of 2018 concerning Health Insurance]. https://djsn.go.id/berita/press-release-djsn-terkait-perpres-nomor-59-tahun-2024-tentang-perubahan-ketiga-atas-perpres-nomor-82-tahun-2018-tentang-jaminan-kesehatan
Gunardi. (2022). Buku Ajar Metode Penelitian Hukum [Textbook of Legal Research Methods, First Edition]. Damera Press.
Gusman, Y. (2024). Update Kebijakan dan Implementasi Kelas Rawat Inap Standar (KRIS) [Update on Standard Inpatient Class Policy and Implementation (KRIS)]. https://thinkwell.global/wp-content/uploads/2024/07/3.-dr.-Yayan-PKR-Kemenkes-KRIS-USAID.pdf?
Hade, A., & Agus, M. (2019). Kebijakan Kesehatan Nasional [National Health Policy]. In Jurnal Artikel Padang (pp. 1–4). https://scholar.googleusercontent.com/scholar?q=cache:oAMT1SDD3QgJ:scholar.google.com/+pengertian+administrasi&hl=id&as_sdt=0,5
Hariani, Alfian, H., Heriyati, Arlia, Nurwahyuni, Ilham, M. N., Wahyuddin, Jannah, M., Utami, R. D., & Rahmayanti, H. (2025). Pengantar Administrasi Kebijakan Kesehatan [Introduction to Health Policy Administration]. Yayasan Tri Edukasi Ilmiah.
Hart. (2012). The Concept of Law, Third Edition Published. Oxford University Press.
Hutagaol, R., Fauziah, E., Ardiansyah, F., Enjelia, D., & Avia, I. (2025). Bureaucratic Caring dalam Praktik: Refleksi Empiris Peran BPJS terhadap Kesejahteraan Janin (Fetal Well-Being) [Bureaucratic Caring in Practice: An Empirical Reflection on the Role of BPJS in Fetal Well-Being]. Penerbit NEM.
Ilmansyah, V. D., & Basabih, M. (2025). Analisis Kesiapan Implementasi Kebijakan Kelas Rawat Inap Standar Jaminan Kesehatan Nasional Rumah Sakit Umum Daerah DKI Jakarta [Analysis of Readiness for Implementation of the National Health Insurance Standard Inpatient Class Policy at DKI Jakarta Regi. JURNALLOCUS:Penelitian & Pengabdian, 4(4), 1598–1608. https://doi.org/10.58344/locus.v4i4.4101 [In Indonesian]
Imtihani, H., & Nasser, M. (2024). Keadilan dalam Reformasi BPJS: Teori Rawls dan Kajian Kritis Terhadap Kebijakan Kelas Rawat Inap Standar [Justice in BPJS Reform: Rawls’ Theory and a Critical Study of the Standard Inpatient Class Policy]. Syntax Idea, 6(9), 3832–3842. https://doi.org/10.46799/syntax-idea.v6i9.4447 [In Indonesian]
Institute, I. (2008). Bismarck Versus Beveridge: A Comparasion of Social Insurance System in Eroupe. https://www.ifo.de/DocDL/dicereport408-db6.pdf?utm_
Kertati, I., Pratomo, S., Sancono, B. A. W., Daeni, M., Widyastomo, R. P., Christiani, C., Werdiningsih, R., Hadiati, T. L., Bahrudin, A., & Winarni, A. T. (2023). Implementasi Kebijakan Publik: Dari Hulu ke Hilir [Public Policy Implementation: From Upstream to Downstream]. PT. Sonpedia Publishing Indonesia.
Kholdun, A. I., Ismoyowati, T. W., Setianingsih, L. E., Hutagaol, E. K., Suharso, E., & Rahardjo, W. (2025). Sistem Manajemen Transformasi Kesehatan: Strategi, Inovasi dan Implementasi Menuju Layanan Kesehatan Berkelanjutan [Health Transformation Management System: Strategy, Innovation and Implementation Towards Sustainable Health Services]. PT. Sonpedia Publishing Indonesia.
Majeed, N., Hilal, A., & Khan, A. N. (2023). Doctrinal Research In Law: Meaning, Scope, and Methodology. Tahun, 12(4), 559–563. https://doi.org/10.61506/01.00167
Marzuki, P. M. (2005). Penelitian Hukum [Legal Research]. Prenada Media.
Masula, F., Aini, N. Q., & Winarno, A. (2025). Eksplorasi Kritis : Pengaruh Teori Positivisme dan Teori Kritis Dalam Pembentukan Kebijakan Publik Melalui Systematic Literature Review [Critical Exploration: The Influence of Positivism Theory and Critical Theory in the Formation of Public Policy Through. Santhet (Jurnal Sejarah Pendidikan Dan Humaniora), 9(3), 842–850. https://doi.org/10.36526/santhet.v9i3.5320 [In Indonesian]
Muhaimin. (2020). Metodologi Penelitian Hukum [Legal Research Methodology]. Mataram:Mataram University Press.
Muliani, C. W., & Suryono, A. (2025). Analisis Hukum Ekonomi terhadap Kebijakan Kelas Rawat Inap Standar (KRIS) dalam Upaya Mewujudkan Efisiensi dan Keadilan Jaminan Kesehatan Nasional [Economic Law Analysis of the Standard Inpatient Class (KRIS) Policy in an Effort to Achieve Efficiency and . Jurnal Locus Penelitian Dan Pengabdian, 4(9), 8840–8848. https://doi.org/10.58344/locus.v4i9.4811 [In Indonesian]
Mushafi. (2025). Metode Penelitian Hukum [Legal Research Methods]. CV. Eureka Media Aksara.
Nugraha, A. (2024). Determinan dalam Kepesertaan Program Jaminan Kesehatan Nasional [Determinants of National Health Insurance Program Participation]. Penerbit NEM.
Nugroho, H., Widyanta, A. B., Wibawanto, G. R., & Fitramadhana, R. (2023). Proliferasi Pemikiran Sosial Kritis [Proliferation of Critical Social Thought]. PT Kanisius.
Nurhadi. (2024). Jaminan Sosial di Indonesia: Sejarah, Teori dan Tantangan Masa Depan [Social Security in Indonesia: History, Theory and Future Challenges]. In Friedrich Ebert Stiftung.
Nurhayati, Telaumbanua, N., Hati Daeli, L. J., Agustin, D., Khairunisa, S. S., Aulia, J., & Syifaurridha, N. (2025). Masalah Kebijakan Kesehatan [Health Policy Issues]. Innovative: Journal Of Social Science Research, 5(4), 45–55. https://doi.org/10.31004/innovative.v5i4.20143 [In Indonesian]
Pramono, J. S., Hasanah, S., Ardyanti, D., & Tonapa, E. (2025). Jaminan Kesehatan Nasional: Strategi, Implementasi dan Transformasi Kesehatan [National Health Insurance: Strategy, Implementation and Health Transformation]. Penerbit Adab.
Purwono, R. (2023). Jaminan Kesehatan Nasional [National Health Insurance]. Cipta Media Nusantara.
Puspita, R., & Arimbi, D. (2023). Regulasi Kelas Rawat Inap Peserta Jaminan Kesehatan Nasional [Regulations on Inpatient Classes for National Health Insurance Participants]. MEGA PRESS NUSANTARA.
Putri, N. A. S., Salsabila, S. S., Jamal, N., Adinda, A. S., Bua, R. T., & Apriliani, A. (2025). Akses Layanan Kesehatan [Access to Health Services]. ARSY MEDIA.
Rachim, A. (2025). Pemasaran Kebijakan Publik: Membangun Sistem Pelayanan Kesehatan Berbasis Masyarakat [Public Policy Marketing: Building a Community-Based Health Care System]. PT. Star Digital Publishing, Yogyakarta-Indonesia.
Ramos, A. M., Leite, E., Nuno, H., & Alves, S. R. P. (2022). From Bismarck To Beveridge: Contributions For The Understanding Of Different Social Security Models. 79th International Scientific Conference on Economic and Social Development.
Ratman, M. N., Amanda, N. N., Oktapia, S., & Pangestoeti, W. (2025). Program Kelas Rawat Inap Standar (KRIS): Analisis Ekonomi Publik atas Pemerataan Layanan Kesehatan Nasional [Standard Inpatient Class Program (KRIS): A Public Economic Analysis of the Equity of National Health Services]. Jurnal Ilmu Komunikasi Dan Sosial Politik, 2(4), 1303–1308. https://doi.org/10.62379/jiksp.v2i4.2924 [In Indonesian]
Rawls, J. (1971). A Theory of Justice (revised). The Belknap Press of Harvard University Press.
Reporter. (2025). Hot Isu Pagi Ini, Anak Buah Megawati Desak Menkop Budi Arie Setiadi Segera Minta maaf [This Morning’s Hot Issue: Megawati’s Staff Urges Cooperatives Minister Budi Arie Setiadi to Immediately Apologize]. https://reporter.id/2025/05/27/hot-isu-pagi-ini-anak-buah-megawati-desak-menkop-budi-arie-setiadi-segera-minta-maaf/#:~:text=dari total 3,KRIS di aplikasi RS online
Rezah, F. S., & Qamar, N. (2020). Metode Penelitian Hukum Doktrinal dan Non-Doktrinal [Doctrinal and Non-Doctrinal Legal Research Methods]. CV. Social Politic Genius.
Rivai, A. F. (2024). Kebijakan Kesehatan dan Keperawatan [Health and Nursing Policy]. Deepublish.
Sabarudin, D. (2024). DISKURSUS EKONOMI: Perdebatan-Pertaruhan Ideologi dan Politik dalam Ruang Publik Relasi Ekonomi-Politik-Hukum dan Opini Publik (Tinjauan Omnibus Law Cipta Kerja) [ECONOMIC DISCOURSE: Ideological and Political Debates and Stakes in the Public Sphere: Econo. PT. RajaGrafindo Persada-Rajawali Pers.
Signe, L. (2017). Policy Implementation- A Synthesis of the Study of Policy Implementation and the Causes of Policy Failure, 2017. OCP Policy Center. https://www.policycenter.ma/sites/default/files/OCPPC-PP1703.pdf?utm_
Sitomorang, C. H. (2025). Implementasi Perpres JKN 59/2024 [Implementation of Presidential Decree No. 59/2024 on National Health Insurance (JKN)]. Kompasiana.com.
Sudastra, I. N. (2020). Perlindungan Hukum Pasien Jaminan Kesehatan Nasional Mandiri: Pembatasan Naik Kelas Rawat Inap [Legal Protection for Independent National Health Insurance Patients: Limitations on Inpatient Class Upgrades]. SCOPINDO MEDIA PUSTAKA.
Sudrajat, A. S., & Rahayu, R. H. (2025). Impementasi Kebijakan Rawat Inap Standar Jaminan Kesehatan Nasional (KRIS-SJSN) di RSUD Kota Bandung [Implementation of the National Health Insurance Standard Inpatient Policy (KRIS-SJSN) at Bandung City Regional Hospital]. Maret, 7(1). https://doi.org/10.36636/jogiv.v7iL.5256 [In Indonesian]
Suma, M. A., & Amin, I. Q. (2021). Asuransi Syariah di Indonesia: Telaah Teologis, Historis, Sosiologis, Yuridis dan Futurologis [Sharia Insurance in Indonesia: A Theological, Historical, Sociological, Legal, and Futurological Study]. Amzah (Bumi Aksara).
Suprapto, A. (2024). Perumusan KRIS dan Hal-hal Yang Menjadi Kesepakatan [Formulation of KRIS and Matters That Were Agreed Upon]. In Dewan Jaminan Sosial Nasional. https://thinkwell.global/wp-content/uploads/2024/07/2.-drg.-Agus-DJSN-PERUMUSAN-KRIS-DAN-HAL-HAL-YANG-MENJADI-KESEPAKATAN-USAID.pdf?
Susanti, D. O., & Efendi, A. ’a. (2018). Penelitian Hukum [Legal Research]. Sinar Grafika.
Susanti, Y., Syofyan, S., Khairani, & Hermanto, B. (2024). Hak Pasien dalam Menentukan Layanan Kesehatan dalam Hubungannya dengan Kelas Rawat Inap Standar BPJS Kesehatan [Patient Rights in Determining Health Services in Relation to BPJS Health Standard Inpatient Classes]. Https://Review-Unes.Com/, 6(4), 12184–12193. https://doi.org/10.31933/unesrev.v6i4.2190 [In Indonesian]
Tarigan, R. S. (2024). Hukum Tata Negara dan Transformasi Implikasi dan Prospek Sosial [Constitutional Law and the Transformation of Social Implications and Prospects]. Ruang Karya Bersama.
Winastya, K. P., & Saputra, E. (2025). Kelas 1,2,3 BPJS Kesehatan Dihapus, Segini Iuran Cara Mendaftarnya [BPJS Health Classes 1, 2, and 3 Eliminated, Here’s How Much You Need to Pay to Register]. https://www.merdeka.com/trending/fakta-terkini-kelas-123-bpjs-kesehatan-dihapus-segini-iuran-dan-cara-mendaftarnya-kris-belum-resmi-berjalan-mvk.html?page=2
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