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ASEC 2018

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VERIFY

I recorded that (name/you) (are/is) not currently covered by a health plan. Is that correct?

1 Yes, is NOT covered
2 No, is covered

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ASEC 2017

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VERIFY

I recorded that (name/you) (are/is) not currently covered by a health plan. Is that correct?

1 Yes, is NOT covered
2 No, is covered

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ASEC 2016

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VERIFY

I recorded that (name/you) (are/is) not currently covered by a health plan. Is that correct?

1 Yes, is NOT covered
2 No, is covered

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ASEC 2015

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VERIFY

I recorded that (name/you) (are/is) not currently covered by a health plan. Is that correct?

1 Yes, is NOT covered
2 No, is covered

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ASEC 2014

No questionnaire text is available for this sample.

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ASEC 2013

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SHIC4

I have recorded that (you/read list of names) (were/was) not covered by a health plan at any time during 2012. Is that correct?

1 Yes
2 No

SHIC4A

Who should be marked as covered? Enter all that apply, separate using the space bar or a comma. Probe: Anyone Else?

Enter persons line number (1-16)

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ASEC 2012

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SHIC4

I have recorded that (you/read list of names) (were/was) not covered by a health plan at any time during 2011. Is that correct?

1 Yes
2 No

SHIC4A

Who should be marked as covered? Enter all that apply, separate using the space bar or a comma. Probe: Anyone Else?

Enter persons line number (1-16)

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ASEC 2011

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SHIC4

I have recorded that (you/read list of names) (were/was) not covered by a health plan at any time during 2010. Is that correct?

(1) Yes
(2) No

SHIC4A

Who should be marked as covered?

Enter all that apply, separate using the space bar or a comma.
Probe: Anyone else?
Enter persons line number (1-16)

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ASEC 2010

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SHIC4

I have recorded that (you/read list of names) (were/was) not covered by a health plan at any time during 2009. Is that correct?

(1) Yes
(2) No

SHIC4A

Who should be marked as covered?

ENTER ALL THAT APPLY, SEPARATE USING THE SPACE BAR OR A COMMA.
PROBE: Anyone else?
ENTER PERSONS LINE NUMBER (1-16)

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ASEC 2009

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SHIC4

I have recorded that (you/read list of names) (were/was) not covered by a health plan at any time during 2008. Is that correct?

(1) Yes
(2) No

SHIC4A

Who should be marked as covered?

ENTER ALL THAT APPLY, SEPARATE USING THE SPACE BAR OR A COMMA.
PROBE: Anyone else?
ENTER PERSONS LINE NUMBER (1-16)

Questionnaire Text