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The Pennsylvania State University The Pennsylvania State University The Graduate School School of Public Affairs POLICY ISSUE NETWORKS IN THE STATE CHILDREN’S HEALTH INSURANCE PROGRAM (SCHIP) IN ILLINOIS: A LONGITUDINAL CASE STUDY A Dissertation in Public Administration by Sohee Kim © 2016 Sohee Kim Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy August 2016 The dissertation of Sohee Kim was reviewed and approved* by the following: Göktuğ Morçöl Professor, School of Public Affairs Dissertation Adviser Chair of Committee Program Coordinator, Doctor of Philosophy in Public Administration Bing Ran Associate Professor, School of Public Affairs Triparna B. Vasavada Associate Professor, School of Public Affairs Rhoda Joseph Associate Professor, School of Business Administration *Signatures are on file in the Graduate School. ii Abstract In policy processes large numbers of actors who hold various forms of scientific and technical information, beliefs, and values interact with each other in political and institutional contexts. The purpose of this study is to investigate the complex policy processes in the health policy area in Illinois, using two theoretical lenses: the policy network theory (PNT) and the advocacy coalition framework (ACF). The PNT helps us understand the complex networked relationships among the actors of public policy processes. The ACF helps us explore more specifically the belief systems of network actors and the roles such beliefs play in policy network formation and policy change. Using the PNT and the ACF frameworks, in this dissertation I examined the policy network characteristics and policy changes in the case of the State Children’s Health Insurance Program (SCHIP) in Illinois from 1997 to 2007. In my study I used AutoMap, a network analyses tool, and ORA, a dynamic network analysis tool. Using this combination of methods, I extracted meta-networks from the newspaper articles on the SCHIP process in Illinois and analyzed them to identify the policy networks and subnetworks (subgroups) and the values attached to these subgroups. I first discuss the background of the Illinois SCHIP policy process and the theoretical frameworks I applied in my study (PNT and ACF). After describing and discussing the analytical tools I used (AutoMap and ORA), I present the findings on the structural characteristics of policy networks in the Illinois SCHIP policy process. Next I present the results of a series of cluster analyses, which revealed the groups of actors who formed the advocacy policy coalitions, and compare these results with the predictions of the ACF. I found that in the SCHIP Illinois case and in the period I studied the iii predictions of ACF were only partially confirmed: I could identify some pro- and against- policy coalitions, but their membership or the values attached to them were not consistent between 1997 and 2007. Instead, ORA identified the clusters of networks (subnetworks) of policy actors and their beliefs. I conclude that in interpreting the findings it is better to use the relatively broader term of “policy issue networks” or “policy issue coalitions,” instead of the ACF’s more specific term of “advocacy coalitions.” My dissertation makes a contribution to the policy literature by introducing innovative methods of network text analysis (AutoMap) and dynamic network analysis (ORA) to identify policy networks and subnetworks in texts. It also makes a contribution by presenting an understanding of the interplay between key policy actors and their beliefs and network characteristics. The methods applied in this dissertation may be used in future studies on policy processes and the findings may be compared with those of future studies to gain a better understanding of policy networks. iv Table of Contents List of Tables ................................................................................................................... vii List of Figures ................................................................................................................. viii Acknowledgements ........................................................................................................... x CHAPTER 1. INTRODUCTION .................................................................................... 1 1. Background of the Problem ......................................................................................... 2 2. Statement of the Problem ............................................................................................ 5 3. Purpose of the Study ................................................................................................... 8 4. Research Questions ..................................................................................................... 9 5. Significance of the Study .......................................................................................... 13 CHAPTER 2. A BACKGROUND OF ILLINOI’S STATE CHILDREN’S HEALTH INSURANCE PROGRAM (SCHIP) ............................................................................. 16 1. A Background of SCHIP at the Federal Level .......................................................... 16 2. History and Policy Context of the SCHIP in Illinois ................................................ 27 CHAPTER 3. THEORETICAL FRAMEWORK OF THE STUDY ........................ 36 1. Theoretical Explanations of Policy Networks ........................................................... 36 A. A Historical Background of Policy Network Theories ......................................... 36 B. The Network Perspective in the Field of Public Administration and Public Policy ................................................................................................................................... 50 2. Network Approach and the Advocacy Coalition Framework ................................... 58 3. Issue Networks and Advocacy Coalition Framework ............................................... 63 4. Resource Dependence Theory, Advocacy Coalition Framework, and Network Theories ......................................................................................................................... 66 CHAPTER 4. PROPOSED MODEL OF POLICY NETWORK STRUCTURE AND POLICY CHANGE ........................................................................................................ 71 CHAPTER 5. METHODS ............................................................................................. 81 1. Case Selection ........................................................................................................... 81 2. Data Collection .......................................................................................................... 84 v 3. Data Analyses ............................................................................................................ 88 A. Network Text Analyses: AutoMap ....................................................................... 90 B. Social Network Analyses: ORA ........................................................................... 92 C. Interpretations of Texts ......................................................................................... 95 CHAPTER 6. RESULTS OF SCHIP NETWORK ANALYSES ............................... 97 1. Group Level Analyses ............................................................................................... 97 2. Individual Level Analyses ....................................................................................... 100 3. Sub-Group Level Analyses ..................................................................................... 103 CHAPTER 7. CONCLUSIONS ................................................................................... 151 1. Summary and Discussion ........................................................................................ 151 2. Implications ............................................................................................................. 157 A. Theoretical Implications ..................................................................................... 157 B. Methodological Implications .............................................................................. 161 C. Policy Implications ............................................................................................. 164 3. Limitations and Suggestions for Future Research ................................................... 164 References ...................................................................................................................... 167 Appendix ........................................................................................................................ 184 vi List of Tables Table 2.1. Overview of Illinois Medicaid and SCHIP Program Changes ....................... 29 Table 2.2. Key Developments of SCHIP in Illinois .......................................................... 32 Table 3.1. Conceptualizations of Policy Networks in Three Traditions ........................... 48 Table 4.1. Types of Tradable Resources ........................................................................... 75 Table 5.1. Summary of Data Collection Method .............................................................. 86 Table 5.2. The Number of Newspaper Articles ................................................................ 87 Table 6.1. Results of Group-Level Analyses .................................................................... 98 Table 6.2. Total Degree Centrality Rankings
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