What's your health care story?
Does your health care work for you? Does it give you quality care, when you need it, at a price you can afford?
We want to hear from you - share your story:
Sign in to Google to save your progress. Learn more
Email *
Name *
Phone number *
How have struggles with health care affordability impacted your life?
How do you get your health care, and are you happy with it? If yes, why? If no, why?
If the Supreme Court strikes down the Affordable Care Act next year, how would it impact you or people you care about? (Do you have a pre-existing condition, provide coverage for a child under 26, buy insurance on the health insurance exchange, get a subsidy to afford insurance on the exchange?)
If there was another, more affordable health care plan that you could buy into (lower deductibles, premiums, copays) how would that affect your life?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.