Table 6. Population coverage rates and uninsured population groups under the HF schemes.

Country, HF scheme	Registered IWs as a share of eligible group	Share of total population registered under HF scheme (formal and informal)	Population groups without coverage under HF scheme
Cambodia HEF extension	5.12% (2020) [100]	0.26% (43,239) (2020) [100]a	HEF extension has so far failed to achieve significant population coverage of the designated groups. Additionally, non-poor self-employed IWs and other IWs working full-time are ineligible under the HEF extension and currently not covered under any other HF scheme.
Indonesia JKN	32.3 million (% share not available) (2019) [104]	83.6% (222,500,000) (2019) [69]	After initial fast membership growth of IWs (30.78%/month), the growth has slowed down to 6.55% (2015) and 2.17% (2016); dropout rates for these groups are also high (47% of members discontinued premium payments in October 2018). About 48.1% of IWs were uninsured in 2016 [112] and make up the bulk of the individuals who are currently uncovered under JKN (43.6 million, 2019); the highest number of uninsured people is part of the lower middle-income group [65, 103, 104].
Lao PDR NHI	No data availableb	94% (2018) [69, 70]	No data available#
Malaysia NHS	100% (2021) [52, 71]	100% (2021) [52, 71]	None. All Malaysians are entitled to access public health services for free or at low nominal user fees [52, 71].
Myanmar SSS	Negligible [60, 101]	5% (1,089,559) (2017) [60]	No system has been established yet for IWs to register themselves directly to Myanmar’s contributory SSS. Additionally, information on the scheme is not easily available. Only a negligible share of the eligible IWs is aware of the scheme and, though entitled by law, they are thus effectively excluded [60].
Philippines NHIP	18,146,517 (2020, % share not available) [124]b	85% (93,372,092) (2020) [124]	Despite that every Filipino is automatically included under the NHIP since the signing of the UHC Act, about 11 million are currently not registered. The composition of this group is not known, though near-poor and self-employed IWs are expected to make up a large share [66]. Lack of awareness of and inability to navigate the health system to access their entitlements have been reported as main reasons for the coverage gaps [66, 67, 76]. This is shown, for instance, by the lower self-reported PhilHealth membership as compared to the rate claimed by PhilHealth [76].
Thailand UCS	Close to 100% (2020) [97]	76% (68,200,000) (2020) [97]	Persons awaiting proof of Thai nationality cannot access UCS until they are granted Thai citizenship. Undocumented migrants who do not enroll in the voluntary migrant health insurance scheme have to pay out-of-pocket [102].
Vietnam SHI	No disaggregated data available (SHI has 25 enrolment categories, and IWs can fall into several of them) [56]b	90.9% (about 88,000,000) (2020) [96]	Population coverage has remained inequitable despite compulsory enrolment. While enrolment rates of low- and high-income groups are high, coverage of the “missing middle” (i.e. the near-poor and the non-poor, particularly the self-employed and small enterprise owners) has remained low. Additionally, substantial delays in issuing health insurance cards and a lack of communication campaigns have been inhibiting citizens’ access to entitlements in mountainous areas. However, the exact group composition of the currently unenrolled is unknown because there is neither a connection between the SHI and their taxation number nor their national identity number [56, 74, 85, 94, 105].

Abbreviations: HEF = Health Equity Fund; HF = health financing; IW = informal worker; JKN = Jaminan Kesehatan Nasional; NHI = National health Insurance; NHIP = National Health Insurance Program; NHS = National Health Service; SHI = Social Health Insurance; SSS = Social Security Scheme; UCS = Universal Coverage Scheme; UHC = universal health coverage.

^a The Cambodian HEF extension is only aimed at covering approximately 8.3% of working-age adults.

^b No such data was found in the literature searches. However, such data might exist in unpublished form or published in languages other than English.