Narrative Coalitions and Fluid Character Roles in Health Policy Crisis: A Narrative Policy Framework Analysis of Indonesia's National Health Insurance Controversy

Abstract* Background In early 2026, Indonesia’s Ministry of Social Affairs deactivated 11,085,286 Contribution-Assisted Beneficiary (PBI) participants of the National Health Insurance (JKN), triggering widespread service refusals and public controversy. Using the Narrative Policy Framework (NPF), this study examines how online media constructed competing narratives around the crisis and how narrative construction differed between opposing media coalitions. Methods A sequential explanatory mixed-methods design was applied to a corpus of 3,897 online news articles (from 1,147 outlets, 29 January–30 April 2026). Quantitative content analysis mapped tone, actor frequency, and temporal patterns; eight core outlets (four pro-policy, four critical) were purposively selected for in-depth qualitative NPF coding of setting, characters, plot, and moral of the story across 576 stratified-sampled articles, with intercoder reliability and source triangulation applied. Results Narrative Coalition A (pro-policy, 199 articles) emphasized data and fiscal settings, the Data Reform plot (68.3%), and a ‘just policy’ moral; Narrative Coalition B (critical/advocacy, 377 articles) emphasized acute-health and constitutional-rights settings, the Governance Crisis plot (35.8%), and a ‘government accountability’ moral. The same officials were positioned as Hero in one coalition and Villain in the other, and one actor was received positively by both coalitions simultaneously, revealing dual and dynamic character roles not anticipated by conventional NPF. The crisis narrative was episodic, peaking in February 2026 and receding after government intervention. Conclusions Policy narratives in this health-insurance crisis were systematically constructed along media outlets’ institutional affiliation with the state rather than random variation. This study confirms NPF’s applicability to Indonesian health-social policy and proposes a ‘fluid character role’ extension to account for dual and time-varying Hero/Villain positioning in short-term, multi-actor policy crises.