Uneven Ground: Differences in Language Access Across State-Based Marketplaces

By Christine Monahan, Jalisa Clark, and Nadia Stovicek

The annual Marketplace Open Enrollment Period is just around the corner. Enrolling in health insurance can be a challenge, especially for the millions of Americans with limited English proficiency (LEP). Individuals with LEP have less access to suitable health care materials and remain three times more likely to be uninsured compared to English-speaking individuals.

Federal law requires the Affordable Care Act (ACA) Marketplaces, including state-based Marketplaces (SBMs), to provide LEP individuals access to critical resources for health insurance enrollment. However, SBMs generally have flexibility with respect to the “reasonable steps” they implement to meet the broadly defined requirements. 

In a new issue brief for the Commonwealth Fund, CHIR experts document the various policies and practices SBMs have implemented to facilitate access to health insurance information for LEP individuals and otherwise meet their needs. Using SBM survey responses and interviews with state officials, the authors describe SBM strategies to collect consumer language data, provide multilingual services at call centers, translate written materials, and plan outreach efforts. The authors also identify persistent gaps in language services, and provide recommendations for federal policies to improve language access in the ACA Marketplaces. You can read the full issue brief here.

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