Affordable Care Act Reaction Survey Question Title * 1. Do you have a pre-existing condition? If so, what conditions were you diagnosed with? yes no Other (please specify) Question Title * 2. Were you insured prior to the ACA? yes no Question Title * 3. When the ACA became effective, did you have to select a new plan? n/a yes no Question Title * 4. Has your premium increased? If so, by how much? yes no remained about the same Other (please specify) Question Title * 5. Has your deductible increased, decreased or remained about the same after enrolling in the ACA? n/a decreased increased remained about the same Other (please specify) Question Title * 6. Has your coverage increased, decreased or did not change (in the services important to you)? did not change n/a increased decreased Question Title * 7. Has the price of your prescriptions increased, decreased or remained about the same? n/a increased decreased remained about the same Question Title * 8. Were you able to keep the same prescriptions that you had prior to the ACA? n/a yes no Other (please specify) Question Title * 9. Have you suffered adverse reactions due to drug changes? yes no Question Title * 10. Were you able to keep the same specialists through the ACA? n/a yes no Other (please specify) Question Title * 11. Were you better off before or after the ACA? before after about the same Other (please specify) Question Title * 12. If you were uninsured prior to the ACA, was it due to having a preexisting condition or being unable to afford a premium? preexisting condition unable to afford a premium I was insured prior to the ACA Comment Question Title * 13. Do you have concerns about the accessibility of specialists under the ACA? yes no n/a Comment Question Title * 14. Do you have an autoimmune disease and have been treated with an immunosuppressant (biologics) and experienced a significant improvement to your quality of life and ability to work? yes no n/a If yes, what medication(s)? Question Title * 15. If you were previously uninsured, were you able to enroll in the ACA? yes no because I could not afford the premium no because I did not qualify for a subsidy n/a Other (please specify) Question Title * 16. Which category below includes your age? 17 or younger 18-20 21-29 30-39 40-49 50-59 60 or older Question Title * 17. What is your gender? female male Question Title * 18. Zip code Question Title * 19. Additional comments? Question Title * 20. We may want to contact you for further information or clarification regarding the answers that you submitted. Please submit your email address. This is optional. Question Title * 21. If you would like a free copy of this report when it is completed, please provide the email address at which you would like to receive the report. Thank you for your participation. Done