Health Reform's Success Depends on Language Access

March 23 marks the third anniversary of the Affordable Care Act. As we celebrate this year's birthday, let's make sure that all communities, including those who don't speak English, are able to benefit.
03/22/2013 12:53 pm ET Updated May 22, 2013

This isn't groundbreaking news, but shopping for health insurance is difficult. In addition to cost issues, there are a number of obstacles that keep more than 45 million people in this country from getting covered. Finding and comparing insurance companies, individual plans and the different ways in which they are structured is confusing. That's even before you get to the paperwork and the litany of questions a person has to answer just to apply!

And unfortunately, selecting a plan is not much easier. Comparing co-pays, deductibles and premiums is a rigorous mental exercise that will give anyone a headache. It can be a logistical nightmare.

Fortunately, the process is about to get a lot easier and more affordable starting this October. The Affordable Care Act, or health reform, helps to level the playing field for individuals, families and small businesses looking for coverage. Starting Oct. 1, Americans will be able to shop for, purchase and enroll in a health insurance plan that meets their budget, all in one competitive marketplace. The online marketplace will allow individuals, families and small businesses to easily compare the price, benefits and out-of-pocket costs between plans and choose the plan best for them.

These changes are a revolutionary approach to health care enrollment, but what happens if you don't speak English very well or not at all? This is the issue states and the federal government are confronting right now and something that will be a major barrier for millions come October.

About one out of four people looking for coverage in the new marketplace will speak a language other than English at home. For non- or limited-English speaking Asian Americans, Pacific Islanders and Latinos -- more than 24 million nationwide -- signing up for Medicaid or navigating through the health insurance marketplace, presents many challenges and puts these populations at risk of being left behind.

Although the health care law requires the marketplaces to hire individuals and organizations known as "navigators" who can help people who do not speak English, it's uncertain how many navigators will be deployed or where and whether it will be enough to meet the high demand across the country.

There is also the question of the application materials. Many states will use a new single application to help streamline the process for determining what type of coverage a person qualifies for and getting people enrolled. But, the application will only be successful if it's fully translated into languages other than English and Spanish. This is a critical issue for Asian American and Pacific Islander communities, where more than 4 million people living in the U.S. primarily speak a language other than English (U.S. Census Bureau, 2010 American Community Survey 1-Year Estimates).

Thanh*, a young Vietnamese American, knows the effects that language barriers can have all too well. As a young adult, he helped his limited English speaking parents enroll in Medicaid. When he went away to college, his parents lost their Medicaid coverage because they couldn't navigate the system and re-enroll on their own.

Data from a recent report shows that unfortunately, Thanh's story is all too common. Over 100,000 people in California alone are expected to miss out on health reform due to language barriers.

The good news is we know how to fix this problem. Translating the common application that millions of Americans will use into at least 15 languages including Arabic, Armenian, Chinese, Farsi, French, Greek, Haitian-Creole, Italian, Korean, Polish, Portuguese, Spanish, Russian, Tagalog and Vietnamese would be a major start. This would make applying for coverage easier and save states the cost of having to do the translations themselves.

In addition, the federal government can develop language glossaries that include standard translations of commonly used health care terms. Marketplace entities, states, navigators and even qualified interpreters assisting consumers with the enrollment process would be able to use these glossaries to communicate important information to limited English speakers.

Taking these steps will dramatically reduce the chance that individuals with language needs are erroneously denied coverage because they do not understand what information they need to provide to get enrolled. Creating these tools will also support the central pillar of health care reform -- to provide affordable health care coverage for all Americans.

March 23 marks the third anniversary of the Affordable Care Act. As we celebrate this year's birthday, let's make sure that all communities, including those who don't speak English, are able to benefit.

*Last name withheld to protect privacy.

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