Cognitive Research on Experimental CPS Health Insurance Questions

DEMOGRAPHICS

1. What are the names of all persons living or staying [here/at your home]? (Let’s start with you.)

PROBE: Anyone else?

2. READ IF NECESSARY

SEE FLASHCARD A ON RELATIONSHIPS

For Person 2: How is NAME related to you?

For Persons 3+: And how about NAME? (How is NAME related to you?)

He/She is your...

(1) Husband/Wife

(2) Unmarried partner

(3) Child (biological/step/adopted)

(4) Grandchild

(5) Mother/Father

(6) Brother/Sister

(7) Other relative (Uncle, Cousin, In-law, etc.)

(8) Foster child

(9) Housemate/roommate

(10) Roomer/boarder

(11) Other nonrelative

3. READ IF NECESSARY:

For Persons 2+: Is NAME male or female?

For Persons 3+: And how about NAME? (Is NAME male or female)?

4. For Person 1: What is your age?

For Persons 2+: And how about NAME? (What is NAME’S age?)

5. For Person 1: Are you Spanish, Hispanic, or Latino?

For Persons 2+: And how about NAME? (Is NAME Spanish, Hispanic, or Latino?)

6. SEE FLASHCARD B ON RACE

For Person 1: Is your race White, Black, American Indian or Alaska native, Asian, or Native Hawaiian or other Pacific Islander? You can choose more than one race.

For Persons 2+: And how about NAME? (Is NAME’S race White, Black, American Indian or Alaska native, Asian, or Native Hawaiian or other Pacific Islander? You can choose more than one race.)

(1) White

(2) Black or African-American

(3) American Indian or Alaska native

(4) Asian

(5) Native Hawaiian or other Pacific Islander

7. ASK ONLY FOR PEOPLE AGE 15+

SEE FLASHCARD C ON EDUCATION

For Person 1: What is the highest degree or level of school you have COMPLETED?

For Persons 2+: How about NAME? (What is the highest degree or level of school NAME has COMPLETED?)

(1) No schooling

(2) Nursery school to 6^th grade

(3) 7^th or 8^th grade

(4) 9^th - 11^th grade

(5) 12^th grade, NO DIPLOMA

(6) High school graduate

(7) Some college, but no degree

(8) Associate's degree (AA, AS)

(9) Bachelor's degree (BA, BS)

(10) Some graduate school, but no degree

(11) Master's degree (MA, MS, MEng, MEd, MSW, MBA)

(12) Professional or Doctorate degree (MD, DDS, DVM, LLB, JD, PhD, EdD)

8. ASK ONLY FOR PEOPLE AGE 15+

For Person 1: Did you ever serve on active duty in the U.S. Armed Forces?

For Persons 2+: How about NAME? (Did NAME ever serve on active duty in the Armed Forces?)

9. ASK ONLY FOR PEOPLE AGE 15+

READ IF NECESSARY:

For Person 1: Are you now married, widowed, divorced, separated, or never married?

For Persons 2+: How about NAME? (Is NAME now married, widowed, divorced, separated, or never married?)

(1) Married

(2) Widowed

(3) Divorced

(4) Separated

(5) Never married