Improving Access to Medicaid for People with Limited English Proficiency

Health care coverage is a proven method of earlier diagnoses, more effective treatment, and overall better health outcomes,1 but language can often be a barrier to obtaining these services. People with limited English proficiency (LEP) are three times as likely as fluent English speakers to be uninsured, for a variety of reasons. First, this disparity is a reflection of their disproportionate employment in jobs that don’t provide employer-sponsored coverage.

Second, among people in these kinds of jobs, their families, and other low income populations, a significant number are eligible for Medicaid but unenrolled. There is no doubt that this population includes many people who are LEP or live with LEP heads of households who need assistance becoming and remaining enrolled in the program.

This brief will focus on the second factor and address the ways in which improvements to the Medicaid system could improve access and therefore health outcomes for LEP individuals. The Department of Health and Human Services (HHS) recognizes that language assistance is a necessary element of the equitable delivery of its programs and activities, which includes Medicaid.

Federal law, and many state laws, require state Medicaid agencies to provide language assistance to people with LEP. However, the ongoing experience of enrollees and the organizations that serve them show that the language assistance being provided is insufficient. This brief provides recommendations both for state Medicaid agencies and HHS’s Centers for Medicare and Medicaid Services (CMS) to address the ways language barriers prevent full access and use of the program.

*For footnotes and bibliography, please reference the PDF version of this resource below.

Read More