Do you currently have health insurance, or not?

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* 1. Do you currently have health insurance, or not?

Were you without health insurance for any amount of time in the past 12 months, or not?

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* 2. Were you without health insurance for any amount of time in the past 12 months, or not?

Who pays for your health insurance? (Check all that apply)

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* 3. Who pays for your health insurance? (Check all that apply)

Which of the following services are covered, in total or in part, by your health insurance plan(s)? (Check all that apply)

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* 4. Which of the following services are covered, in total or in part, by your health insurance plan(s)? (Check all that apply)

Why do you currently not have health insurance? (Check all that apply)

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* 5. Why do you currently not have health insurance? (Check all that apply)

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