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You - Your Health - And Your Story Matter.

You should have a seat at the table in conversations about the future of health care, including Medicaid. Right now, it’s more important than ever to come forward and share your experiences. By telling your story, you help speak for people who may be facing issues just like yours. You have the opportunity to help change the future for millions of Americans.

We're here to help you share your voice - and your photos of you, your family, and why health care matters to you.

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* 1. Please tell us a little bit about your story. How has access to health care made a difference to you or your family? How would losing access, services, or increased costs change your life?

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* 2. Are any of the following true about your story? Check all that apply

I have health insurance through the Health Insurance Marketplace/Healthcare.gov/Obamacare

I have a pre-existing condition.

I am currently uninsured.

I rely on Medicaid for my health care.

My child(ren) are covered by CHIP or Medicaid.

My premiums, deductibles, or other costs are hard for me to afford.

Please share your name (First name, full name, nickname, fake name) so we can share your story with elected officials.

By providing your contact information, we can follow up with you and invite you to other opportunities to share your story, help others share their stories, volunteer, stay informed and other opportunities. You can opt-out at any time.

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* 3. I am willing to talk to someone about my story.

Name: *

Address:

City/Town:

ZIP:

Email Address:

Phone Number:

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* 4. Please upload a photo of yourself or your family to share with your story - and put a face to the importance of health care.

We will share many health care stories with photos with our Senators as they prepare to debate and vote on the future of health care.

By uploading a photo, you agree to allow us to print and share your photo and story with your elected officials.

File size limit is 16MB and PDF, PNG, JPG, JPEG & GIF are uploadable. If your photos are too large, try an online resizer like PicMonkey or PicResize to upload and resize/save as a smaller file.

PDF, JPEG, JPG, PNG, GIF file types only.

Choose File

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* 5. Tell us a little about your photo.

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* 6. Are you interested and/or able to visit your local Senators' and Representative's offices?

Yes, and I will share my health story

Yes, and I will accompany others to support them in sharing their stories

Yes, but I will need transportation

Yes, but I don't think I live near a Congressional office

Maybe, I would like to talk with someone or go with a group

Other (please specify)

Thank you for being willing to share your story. Click "Submit" to send us your information.

If you have any questions, reach out to mohealth@mohealthcareforall.org