Impact of Healthcare Reform

 
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1. Please give your full name.
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2. What County do you reside in?
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3. What is your age?
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4. What is your Occupation?
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5. Do you currently receive health insurance from an employer or do you purchase health insurance from the open market?
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6. Do you currently have individual or family health insurance coverage?
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7. Have you recently received notification that your insurance premiums (both deductible and/or monthly cost) will be higher/lower next year? If so, please describe the change in cost (percentage and dollar amount) in detail.
8. Are there any other thoughts you would like to share regarding health care reform?