ABSTRACT: Insufficient participation in the Independent of National Health Insurance program (Jaminan Kesehatan Nasional or JKN) may exacerbate the financial strain on the government and diminish the quality of healthcare services. Consequently, effective measures are essential to enhance public engagement in this program to bolster the sustainability of JKN and provide fair healthcare services. This study seeks to examine the impact of Ability to Pay (ATP) and Willingness to Pay (WTP) on the engagement of independent participants and to develop policy recommendations to improve the sustainability of JKN membership. The methodologies employed in this study originate from the findings of a national survey on Non-Wage Workers  independent participants or Non-Wage Workers (PBPU) throughout 20 districts/cities in 10 provinces, conducted by Social Security Agency for Health (BPJS Kesehatan), constitute secondary data for this study. Logistic regression with cross-sectional data is employed to estimate the probability of participant activity, scored as 1 for active and 0 for inactive. Research findings indicate that both ATP and WTP exert a simultaneous and considerable influence on the engagement of PBPU participants in the JKN Program. Practical implications include consideration of participant’s ATP attributes; immediate policy recommendations underscore the enhancement of data and the provision of payment flexibility.

KEYWORDS: ability to pay (ATP); National Health Insurance program (JKN); non-wage workers (PBPU); Social Security Agency for Health (BPJS Kesehatan); willingness to pay (WTP).