Response

First Name

Last Name

Cell Phone

Zip

By submitting a story, you agree that you may be contacted by the Office of Congresswoman Garcia for more information. These stories may be used in (but not limited to) social media posts, press releases, and other public communications without identifying information.

RequiredDo you have coverage under the Affordable Care Act?

Yes
No

RequiredIf so, how has it helped you? (write N/A if you answered NO to the previous question)

RequiredIf the premiums were to double, will you still be able to afford health insurance?

Yes
No

RequiredIf you will no longer be able to afford it, how will that impact you and your family? (write N/A if you answered YES to the previous question)