Reducing the number of people without health insurance is the primary goal of the Affordable Care Act (ACA), but individuals with limited English proficiency (LEP) may not receive adequate information in other languages on how to apply and enroll in health insurance plans. In addition, while more individuals with LEP may gain coverage, some are ineligible for Medicaid benefits or premium tax credits due to their immigration status. Nevertheless, as more LEP populations gain coverage, more patients with LEP may prefer to receive health care services in languages other than English. Providing interpretation services to LEP patients reduces language barriers in health care and improves satisfaction, health outcomes and quality of care among LEP populations. Provisions in the Civil Rights Act and the ACA require federal and state governments to provide interpretation services and information in other languages at no cost to LEP populations seeking medical care or coverage through Medicaid and the health insurance marketplaces. Therefore, estimating the number of individuals with LEP by type of health insurance coverage will help policymakers and providers target language-based initiatives that reach LEP populations. Monitoring changes in coverage for the LEP population at the state level requires access to timely, high quality data on LEP populations. The American Community Survey (ACS) is a relatively new source of state-level health insurance coverage estimates, and its large sample size makes it a powerful source of information on relatively small subpopulations, like LEP populations, at the state level. The Appendix at the end of this brief provides detailed information on the ACS and how it compares to other surveys that measure health insurance coverage. Data for this issue brief relies on the most recently available data (2012) in the ACS.
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