The study describes the process used to develop and test survey items targeted to Medicaid consumers for the Consumer Assessment of Health Plans Study (CAHPS). The study also highlights challenges in locating and surveying Medicaid recipients, and provides recommendations for increasing response rates. Focus groups and cognitive interviews were conducted. The Medicaid survey was field-tested. Concepts irrelevant to Medicaid consumers or that consumers were unable to accurately attribute were discarded. New concepts of health care experiences of Medicaid consumers were added. Item wording and format were refined based on findings from focus groups, cognitive testing, the field test and a literature review. Testing and formatting efforts, in combination with a formal literature review, led to the development of a questionnaire that measures important health care experiences of Medicaid consumers in a "respondent-friendly" format. The recommendations for surveying Medicaid recipients can benefit any survey of a Medicaid population.