25.2 million. That is the number of U.S. citizens with Limited English Proficiency (LEP), as reported by the Migration Policy Institute in a 2010 data brief. In order to capitalize on emerging healthcare reforms, states and insurers, in the midst of implementing their health exchanges, need to ensure that their systems possess the capabilities to accurately communicate health insurance related data to culturally diverse audiences, such as people with LEP.
In February 2012, California Pan-Ethnic Health Network (CPEHN), UC Berkeley Center for Labor Research and Education, and the UCLA Center for Health Policy Research published a policy brief using UCLA’s California Simulation of Insurance Markets (CalSIM) model. This briefing established that although California’s 6.7 million people with LEP stood to benefit greatly from the PPACA implementation, over 110,000 of them would not be able to enroll in the exchange, unless proper multilingual outreach efforts were introduced. The briefing identified that if language does not pose a barrier for exchange enrollment, 53% of the 1.06 million LEP individuals are likely to enroll in the exchange by 2019. However, in the absence of any sufficient multilingual exchange support and outreach efforts, the enrollment percentage is expected to drop to 42%.
In order to successfully maximize exchange and plan enrollments, states and health plans need to introduce appropriate cultural and linguistic measures to address the enrollment barriers faced by individuals with LEP. Insights into individuals’ ACA awareness, primary barriers to enrollment, culturally preferred information mediums and navigators, etc., can help insurers design practical action steps for driving maximum enrollments.
An August 2012 survey conducted by California Program on Access to Care (CPAC) noticed a disparity in ACA awareness among different ethnic and multilingual groups. The cost of coverage and confusion on the eligibility rules ranked among the top barriers to enrollment for ethnic migrant populations.
A simplified enrollment process with easily accessible and comprehensible insurance information, along with short, standardized, and translated forms and applications in native languages, and the availability of bilingual exchange navigators and other measures can considerably simplify the enrollment process for individuals with Limited English Proficiency.
The CPAC survey respondents also gave suggestions on what information they considered useful for enrolling in a health plan or exchange. Details on inclusive health services and benefits, eligibility for coverage, cost estimates, availability of bilingual doctors, etc., are some of the necessary elements that can help LEP individuals in making an educated and informed decision when selecting a health plan or service.
Linguistic competency is fast becoming necessary to maintain high-quality standards and practices in almost all business markets, especially in the insurance and health care sector adding to the complexities associated with buying coverage. Due to their disability, LEP individuals are more vulnerable than the average citizen to challenges in accessing care and coverage and are therefore more likely to remain uninsured unless strategic steps are introduced to address such restrictions. States and health plans may need to improvise and introduce effective multi-lingual outreach strategies and provide adequate language assistance in order to successfully engage millions of individuals with Limited English Proficiency.