How long has it been since you last had health care coverage that paid for doctor's visits or
hospital stays?

0 - Never
1 - Within the past year (anytime less than 12 months ago)
2 - Within the last 2 years (1 year but less than 2 years ago)
3 - Within the last 3 years (2 years but less than 3 years ago)
4 - Within the last 5 years (3 years but less than 5 years ago)
5 - Within the last 10 years (5 years but less than 10 years ago)
6 - 10 years ago or more
7 - Refused
9 - Don't Know

Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicaid probe or the Medicare probe.

1 [goto HILASTMY_A]
2,3 [goto HISTOPJOB_A]
4,5,6,0,RF,DK [goto RSNHICOST_A]

How long has it been since you last had health care coverage that paid for doctor's visits or hospital stays?

0 - Never
1 - Within the past year (anytime less than 12 months ago)
2 - Within the last 2 years (1 year but less than 2 years ago)
3 - Within the last 3 years (2 years but less than 3 years ago)
4 - Within the last 5 years (3 years but less than 5 years ago)
5 - Within the last 10 years (5 years but less than 10 years ago)
6 - 10 years ago or more
7 - Refused
9 - Don't Know

Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicaid probe or the Medicare probe.

1 [goto HILASTMY_A]
2,3 [goto HISTOPJOB_A]
4,5,6,0,RF,DK [goto RSNHICOST_A]

How long has it been since ^SCNAME last had health care coverage that paid for doctor's visits or hospital stays?

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

0 - Never
1 - Within the past year (anytime less than 12 months ago)
2 - Within the last 2 years (1 year but less than 2 years ago)
3 - Within the last 3 years (2 years but less than 3 years ago)
4 - Within the last 5 years (3 years but less than 5 years ago)
5 - Within the last 10 years (5 years but less than 10 years ago)
6 - 10 years ago or more
7 - Refused
9 - Don't Know

Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe.

1 [goto HILASTMY_C]
2,3 [goto HISTOPJOB_C]
4,5,6,0,RF,DK [goto RSNHICOST_C]

How long has it been since you last had health care coverage that paid for doctor's visits or
hospital stays?

0 - Never
1 - Within the past year (anytime less than 12 months ago)
2 - Within the last 2 years (1 year but less than 2 years ago)
3 - Within the last 3 years (2 years but less than 3 years ago)
4 - Within the last 5 years (3 years but less than 5 years ago)
5 - Within the last 10 years (5 years but less than 10 years ago)
6 - 10 years ago or more
7 - Refused
9 - Don't Know

Sample Adults 18+ without known health insurance and answered no, refused or don't know to the Medicaid probe or the Medicare probe.

1 [goto HILASTMY_A]
2,3 [goto HISTOPJOB_A]
4,5,6,0,RF,DK [goto RSNHICOST_A]

How long has it been since ^SCNAME last had health care coverage that paid for doctor's visits
or hospital stays?

Description: Sample child's name
Instruction:
Fill ALIAS of HHSTAT_C=1

0 - Never
1 - Within the past year (anytime less than 12 months ago)
2 - Within the last 2 years (1 year but less than 2 years ago)
3 - Within the last 3 years (2 years but less than 3 years ago)
4 - Within the last 5 years (3 years but less than 5 years ago)
5 - Within the last 10 years (5 years but less than 10 years ago)
6 - 10 years ago or more
7 - Refused
9 - Don't Know

Sample Children 0-17 without known health insurance and answered no, refused or don't know to the Medicaid probe.

1 [goto HILASTMY_C]
2,3 [goto HISTOPJOB_C]
4,5,6,0,RF,DK [goto RSNHICOST_C]

How long has it been since you last had health care coverage that paid for doctor's visits or hospital stays?

0 Never
1 Within the past year (anytime less than 12 months ago)
2 Within the last 2 years (1 year but less than 2 years ago)
3 Within the last 3 years (2 years but less than 3 years ago)
4 Within the last 5 years (3 years but less than 5 years ago)
5 Within the last 10 years (5 years but less than 10 years ago)
6 10 years ago or more
7 Refused
9 Do not Know

Sample Adults 18+ without known health insurance and answered no, refused or do not know to the Medicaid probe or the Medicare probe.

1 = [goto HILASTMY_A]
2,3 = [goto HISTOPJOB_A]
4,5,6,0,RF,DK = [goto RSNHICOST_A]

How long has it been since ^SCNAME last had health care coverage that paid for doctor's visits or hospital stays?

Description Sample child's name
Instruction Fill ALIAS of HHSTAT_C=1

0 Never
1 Within the past year (anytime less than 12 months ago)
2 Within the last 2 years (1 year but less than 2 years ago)
3 Within the last 3 years (2 years but less than 3 years ago)
4 Within the last 5 years (3 years but less than 5 years ago)
5 Within the last 10 years (5 years but less than 10 years ago)
6 10 years ago or more
7 Refused
9 Do not Know

Sample Children 0-17 without known health insurance and answered no, refused or do not know to the Medicaid probe.

1 = [goto HILASTMY_C]
2,3 = [goto HISTOPJOB_C]
4,5,6,0,RF,DK = [goto RSNHICOST_C]

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HISTOP
Question Text:

(book) F18 [fill1: Which of these are reasons [fill2: you/ALIAS] stopped being covered?/Which of these are reasons [fill3:you do/ALIAS does] not have health insurance?]
* Enter up to 5 reasons, separate with commas.

01 Person in family with health insurance lost job or changed employers
02 Got divorced or separated/death of spouse or parent
03 Became ineligible because of age/left school
04 Employer does not offer coverage/or not eligible for coverage
05 Cost is too high
06 Insurance company refused coverage
07 Medicaid/Medical plan stopped after pregnancy
08 Lost Medicaid/Medical plan because of new job or increase in income
09 Lost Medicaid (other)
10 Other (specify)
97 Refused
99 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

(1-9,R,D) [go to HCSPFYR]
(10) [go to HISTOPOT]

Instrument Variable Name: HISTOPOT
Question Text:

? [F1] * Other reason for not having coverage

Verbatim Verbatim response
7 Refused
9 Don't know

Universe Text All persons without known health insurance and an "other" reason for stopping or not having coverage
Skip Instructions:

go to HISTOP for the next person without known health insurance coverage or only single service plans; else, go to HCSPFYR

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HISTOP
Question Text:

(book) F18 [fill1: Which of these are reasons [fill2: you/ALIAS] stopped being covered?/Which of these are reasons [fill3:you do/ALIAS does] not have health insurance?]
* Enter up to 5 reasons, separate with commas.

01 Person in family with health insurance lost job or changed employers
02 Got divorced or separated/death of spouse or parent
03 Became ineligible because of age/left school
04 Employer does not offer coverage/or not eligible for coverage
05 Cost is too high
06 Insurance company refused coverage
07 Medicaid/Medical plan stopped after pregnancy
08 Lost Medicaid/Medical plan because of new job or increase in income
09 Lost Medicaid (other)
10 Other (specify)
97 Refused
99 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

(1-9,R,D) [go to HCSPFYR]
(10) [go to HISTOPOT]

Instrument Variable Name: HISTOPOT
Question Text:

? [F1] * Other reason for not having coverage

Verbatim Verbatim response
7 Refused
9 Don't know

Universe Text All persons without known health insurance and an "other" reason for stopping or not having coverage
Skip Instructions:

go to HISTOP for the next person without known health insurance coverage or only single service plans; else, go to HCSPFYR

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

Instrument Variable Name: HILAST
Question Text:

(book) F17 ? [F1] Not including Single Service Plans, about how long has it been since [fill: you/ALIAS] last had health care coverage?

1 6 months or less
2 More than 6 months, but not more than 1 year ago
3 More than 1 year, but not more than 3 years ago
4 More than 3 years
5 Never
7 Refused
9 Don't know

Universe Text All persons without known health insurance or with only single service plans
Skip Instructions:

go to HISTOP

About how long has it been since {subject's name} last had health care coverage?
FR: SHOW CARD 13.

(1) 6 months or less
(2) More than 6 months, but not more than 1 year ago
(3) More than 1 year, but not more than 3 years ago
(4) More than 3 years
(5) Never
(7) Refused
(9) DK

About how long has it been since {subject's name} last had health care coverage?
FR: SHOW CARD 13.

(1) 6 months or less
(2) More than 6 months, but not more than 1 year ago
(3) More than 1 year, but not more than 3 years ago
(4) More than 3 years
(5) Never
(7) Refused
(9) DK