“Obamacare” and LEPs: How does the law upheld by the Supreme Court affect the translation/interpretation industry?

What a week it’s been in politics! Now that the Health Care Law has finally gone before the Supreme Court, which upheld it on a 5 to 4 vote, those of us who work in medical translation and interpretation on a daily basis want to know: What does this mean for us?! For most Americans, the Health Care Law has been confusing from the start. However, imagine how confusing it could be for those millions of Americans who have limited English proficiency (LEP). This can be even more confusing for them. What are their rights? First, we have to look at what the rights have been so far for these individuals when it comes to language access in health care.

Title VI of the 1964 Civil Rights Act

Executive Order 13166, Title VI of the Civil Rights Act of 1964 states, “No person in the United States shall, on the ground of race, color, or national origin be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance.” (42 U.S.C. Section 2000d). In short, any organization, whether a clinic, hospital or other health care facility that receives federal funding must comply with this executive order by providing language access (free of charge) to LEP individuals. This is also true in areas of law and other fields, but for the sake of this post, we’ll stick to the health care issue at hand.

Unfortunately, many health care facilities will try to get around this law by asking patients to bring a friend or family member who is bilingual, or many times, they’ll have someone on staff come in to “interpret” for LEP patients. For those who work as interpreters and language agency owners or project managers, we know that this is a bigger problem, as those individuals are usually not trained in the medical terminology needed to carry out the appointment, nor are they trained in the fine skill of interpretation. Much of these attempts to weasel one’s way out of providing professional, quality service stems from the fact that these facilities have to foot the bill.

Don’t get us wrong. Many, many hospitals and doctors offices DO comply with Title VI;, however, many, many more do not. According to the National Center on Immigration Policy, LEP individuals accounted for 25.2 million (9%) of the population in 2010, although large concentrations of these demographics were attributed to states like California, Texas, New York, Florida, Hawaii, New Mexico and Massachusetts, among others. More and more states are seeing a rising number in minority populations whose first language is not English. In fact, although the Latino population has had steady growth in the past ten years, just recently, Asian Americans became the fastest-growing minority in the U.S.

So, what does all this have to do with language access in the health care debate?

One of the biggest issues in the political discussion on health care has been cutting costs and allowing all to receive health care and be insured. Although we may not see health care insurance covering the cost of language access for LEP patients anytime soon, we should see money saved by both insurance companies and health care facilities that provide professional language services to patients, as many more individuals will be able to go to the doctor and receive the care they need. Those who do not provide these services, but rather, rely on untrained individuals or (even more sadly) no one at all, will see their costs go up and possibly skyrocket, because miscommunications often lead to more doctor’s visits and adverse events that could have otherwise been avoided by providing proper language access to their LEP patients.

One section of the law discusses the implementation of effective approaches and specifically identifies “the ongoing, accurate, and timely collection and evaluation of data on health care disparities on the basis of race, ethnicity, sex, primary language, and disability status.” This data will be invaluable to many of us and it will be interesting to see if the information on patients’ primary languages affects the way that health care providers are reimbursed for offering professional language access services to patients.

Although up until now health care providers have not reimbursed by Medicare and Medicaid, we may see this change as a result of the passing of the Health Care Law. Provenzano argues, “Ultimately, one of the best arguments for Medicare reimbursement for language services is that the services themselves represent the linguistic equivalent of preventive care. By spending modestly up front to communicate effectively with LEP patients, Medicare—as well as Medicaid and private insurers—can save significantly through the prevention of costly errors.”

For those of us in the interpretation and translation industry, we will see a larger need from our clients who require on-site and telephonic oral interpretation, as well as the translation of vaccination records, consent forms, insurance policies, prescriptions, medical charts, etc. We’ll be on the edge of our seats to see what the next several years hold in store for all of us as Americans, especially LEP patients and we who provide professional language access to them every day.

For more information on LEP rights, please visit http://www.lep.gov/