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Questions marked with a * are required Exit Survey
 
 
* What is your yearly family income?
 
up to $25,000
 
$26,000-$50,000
 
$51,000-$75,000
 
$76,000-$99,000
 
$100,000 plus
 
 
 
* How many people are in your household?
 
one
 
two
 
three
 
four
 
five plus
 
 
 
* Do you have health insurance?
 
yes
 
no
 
 
 
* Have you used the Marketplace to get insurance coverage?
 
yes
 
no
 
 
 
* How have your insurance premiums changed since the adaption of Obamacare into law?
 
gone up
 
gone down
 
stayed the same
 
n/a
 
 
 
* How has obamacare affected your family financially?
 
For the better
 
For the worse
 
no change
 
 
 
* In your opinion, is Obamacare a long-term solution to the healthcare crisis in the United States?
 
yes
 
no
 
 
 
* If using the Marketplace, did you qualify for tax credits to keep your premium lower?
 
yes
 
no
 
n/a
 
 
 
* What political party do you affiliate with?
 
Republican
 
Democratic
 
Independent
 
Libertarian
 
other
 
 
 
* Please give your personal opinion on Obamacare. (responses are confidential).