The Missing Middle: Gig Workers and Unequal Access to Social Protection in Indonesia

Abstract

Notwithstanding Indonesia's advancements in universal health care, female gig workers continue to be insufficiently safeguarded within the Badan Penyelenggara Jaminan Sosial (BPJS) framework. This study analyzes the factors and impacts of gig employment on health insurance enrollment, utilizing data from the 2017 Indonesia Demographic and Health Survey (IDHS) for women aged 15 to 49. Logistic regression and propensity score matching (PSM) were utilized to assess both correlational and causal effects on two BPJS schemes: the government-subsidized BPJS–PBI and the contributory (self- or employer-financed) program. Findings demonstrate that gig workers are markedly less likely to be enrolled in either program, exhibiting an average treatment effect of −0.023 for BPJS–PBI and −0.098 for BPJS–Contributory, even when accounting for age, education, wealth, and household attributes. The data indicate that inconsistent income, bureaucratic obstacles, and insufficient employer affiliation systematically restrict women's access to health protection. The study shows that Indonesia's existing dual-track insurance policy inadvertently excludes individuals in precarious and flexible work. Policy improvements, including flexible premium methods, digital platform integration, dynamic eligibility procedures, and gender-sensitive design, are crucial to closing this protection gap. In the absence of such changes, universal health coverage may exacerbate inequality instead of eradicating it.