The Asian Development Bank (ADB) lowered its forecast for Indonesia’s GDP growth in 2015, despite maintaining its outlook for developing Asia, citing problems with budget disbursement and export delays. The forecast was cut from 4.9% to 4.8% for 2015 and from 5.4% to 5.3% in 2016.

The government has issued six economic packages in an effort to bolster the economy amid the slowdown, focusing on simplified business-permit processing, incentives for investors, and loan support for labor-intensive industries.

In Jakarta, only 40% of the city’s 2015 budget of nearly US$50 billion had been spent, as of November, raising concerns about the progress of much-needed infrastructure projects in the gridlocked capital of 10 million people. Jakarta officials expect as little as half of the budget will be spent this year, with the rest being carried into 2016. Indonesian bureaucrats are holding off spending billions of dollars on everything from schools and clinics to garbage trucks and parking meters, fearful that any major expenditure could come under the scanner of fervent anti-corruption fighters. The paralysis is so bad that President Joko Widodo, desperate to pull Southeast Asia’s largest economy out of a slump, is considering a decree that would shield civil servants from graft busters until big-ticket projects are completed.

Indonesia created the world’s largest national health insurance system in 2014. In its second year, it has been struggling. A deficit has mounted up quickly as more patients sign up to pay nominal premiums ranging from US$1.70-US$4.10 per month for broad medical coverage. It covers everything from check-ups and maternity services to treatments for cancer patients at both public and private hospitals. The program attracted new enrollees with serious and often long unaddressed medical problems that require expensive surgery or long-term treatments.

The looming question is whether Indonesia can afford to offer treatments at the low premiums the system currently charges. The program cost 3.3 trillion rupiah (US$224 million) more than it took in as premiums and from a government fund that covers the premiums for more than 97 million poor Indonesians. The Health Ministry projected that this year’s shortfall might deepen to 13.5 trillion rupiah (US$951 million). To address such financial troubles, Indonesia is undertaking a costly overhaul of the program’s infrastructure but is currently not looking at raising healthcare premiums. Now more than 150 million people are enrolled in the program, BPJS Kesehatan, the government entity running the program, will keep promoting it and ease the bureaucracy to attract those who are used to a simpler process under private, self-paid insurance. After January 1, 2019, enrollment in the system will become mandatory.