Share your Medicaid enrollment experience

The EMEE Voices project is seeking to better understand the barriers that prevent black and brown West Virginians from applying for and gaining access to Medicaid. This survey hopes to gain a better understanding of these systems, whether based around stigma or institutional factors, from the perspective
of Medicaid applicants and users. Please include as much detail as you can.

Your responses are voluntary and will remain confidential. Responses will not be identified by an individual. All responses will be compiled together and analyzed as a group. If you have any further questions, comments, or concerns, please do not hesitate to reach out to Mariah Plante (mariah@wvahc.org) or Rhonda Rogombe (rrogombe@wvpolicy.org). Thank you for taking the time to
fill this out; we look forward to learning from you! 

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* 1. Do you identify as Hispanic or Latino?

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* 2. What is your race?

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* 3. What is your gender?

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* 4. Which pronouns should we use when referring to you?

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* 5. What is your age?

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* 6. How many people currently live in your household?

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* 7. Have you or anyone in your household ever applied for Medicaid or CHIP benefits in West Virginia?

Tell us about your enrollment experience.

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* 8. How did you submit your application for Medicaid?

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* 9. During the initial enrollment process, how did you submit supporting documents to prove your eligibility for Medicaid (such as proof of citizenship, identity, income, etc.)?

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* 10. Please provide further details about which documents you were asked to provide. If none, write N/A.

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* 11. How would you like to submit documents to the Medicaid agency?

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* 12. Was the language and wording of the questions on your application easy for you to understand?

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* 13. In your opinion, how helpful were the customer service representatives who assisted you during the initial Medicaid enrollment process?

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* 14. Which other programs, if any, are you enrolled in?

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* 15. Approximately how far away is your residence from the nearest DHHR office?

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* 16. If you needed to visit your local DHHR office in-person, do you have reliable transportation that could take you there and back (including public transportation and car services like Uber)

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* 17. How often do you have access to broadband/internet, a computer, and/or a smartphone?

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* 18. Which, if any, barriers have you faced that have impacted your ability to sign up for or enroll in Medicaid? Check all that apply.

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* 19. Have you experienced stigma or negative emotions around Medicaid that impacted your ability to sign up for or enroll in Medicaid (from yourself, other people, DHHR or other officials, etc.)?

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* 20. Space for elaborating on Question 19.

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* 21. *Paid storytelling opportunity:
WVCBP and WVAHC are working together to improve the state’s Medicaid enrollment process. If you're interested in sharing more about your enrollment experience with us, please give your contact information down below. Individuals selected for a follow-up interview will be compensated for their time. Your contact information and enrollment experiences are used for research purposes and will not be shared without your consent.

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* 22. Follow up interviews are 45 minutes to 1 hour long and are typically conducted via zoom or over the phone. Will you require technological assistance? Please specify.

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