San Francisco – Non -profit organizations and health medical interpreters warn that federal cuts have eliminated dozens of positions in California for community workers who help non -English speakers to register for insurance coverage and navigate the health care system.
At the same time, people with a limited English competence have reduced their requests for linguistic services, that defenders of health care attributes in part to the repression of immigration by President Donald Trump and his executive decree declaring English as a national language.
Such policy and funding changes could leave some without life care, especially children and the elderly. “People will find it difficult to access advantages to which they have the right and to live independently,” said Carol Wong, principal lawyer for justice in Agging, a national defenders’ group.
In the United States, nearly 69 million people speak a language other than English, and 26 million of them speak less about English Recent data from the American census Available, from 2023. A Kff-Los Angeles Times investigation This year, immigrants with limited English skills have declared more obstacles to access to health care and worse health than Immigrants with English offer.
Health defenders fear that without adequate support, millions of people in the United States with limited English competence are more likely to undergo medical errors, erroneous diagnosis, negligence and other negative results. At the start of the pandemic in 2020, Propublica reported That a woman with symptoms of coronavirus died in Brooklyn after having lacked treatment in a timely manner because the members of the emergency staff could not communicate with her in Hungarian. And, at the top of the crisis, The Virginian pilot was reported for the first time that A Spanish translation On a state website, he wrongly said that the COVVI-19 vaccine was not necessary.
In 2000, President Bill Clinton signed a executive decree aimed at improving access to federal services for people with limited English skills. Research shows that linguistic assistance gives higher results Patient satisfactionas well as Less medical errorsErroneous diagnostics and unfavorable health results. Linguistic services too Save money from the health system By reducing stays and readmissions to the hospital.
Trump’s order has repealed the Clinton directive and left it to each federal agency to decide to maintain or adopt a new linguistic policy. Some have already reduced: the Department of Internal Security and the Social Security Administration would have reduced linguistic services, and the Ministry of Justice says that it is Examination of guidance documents. A Link to his linguistic plan is broken.
We do not know what the Ministry of Health and Social Services intends to do. HHS did not answer questions from KFF Health News.
A hhs plan implemented under President Joe Biden, including advice During public health emergencies and disasters, which means that it may not reflect current policies. However, hhs Civil rights office Always informs patients of their right to linguistic assistance services when they collect a prescription, request from a health insurance plan or visit a doctor.
And the office Adding protections in July This prohibits health service providers from using unspecified staff, family members or children to provide interpretation during medical visits. He also required that translation of sensitive information using artificial intelligence be examined by a human translator qualified for precision.
These guarantees could be canceled by the Trump administration, said Mara Youdelman, director general of the National Health Law Program, a national organization for the defense of legal and health policies. “There is a process that must be followed,” she said, about changes with the public’s contribution. “I would strongly urge them to consider the disastrous consequences when people have no effective communication.”
Even if the federal government ultimately does not offer linguistic services for the public, said Youdelman, hospitals and health providers are required to provide linguistic assistance to patients at no cost.
The title VI of the Civil Rights Act of 1964 prohibits discrimination based on race or national origin, the protections which extend to the language. And the 2010 law on affordable care, which has widened health coverage for millions of Americans and has adopted many consumer protections, obliges health providers to receive federal funds to create linguistic services, including translation and interpretation, available.
“English can be the official language and people always have the right to obtain linguistic services when they access health care,” said YouDelman. “Nothing in the executive decree has changed the real law.”
Insurers must always include multi-language slogans in their correspondence with registrants explaining how they can access linguistic services. And health establishments must display visible opinions informing patients of linguistic assistance services and guarantee certified and qualified interpreters.
States and local governments could expand their own linguistic access requirements. Some states have taken such measures in recent years, and California state legislators are Consider an invoice This would establish a linguistic access director, would oblige the human examination of the translations of AI and improve surveys evaluating linguistic needs.
“With increasing uncertainty at the federal level, the laws and policies of access to states and local are even more consecutive,” said Jake Hofstetter, policies analyst in the Policy Institute migration.
The Los Angeles Department of Public Health and the Civic Commitment and Immigrants Office of San Francisco said that their linguistic services had not been affected by the executive order of Trump or the federal financing cuts.
However, the demand has dropped. Aurora Pedro de Comunidades Indígenas en Liderazgo, one of the few medical interpreters in Los Angeles who speaks Akatek and Qʼanjobʼal, the Mayan languages of Guatemala, said that she had received fewer calls for her services since Trump took office.
And other California pockets have reduced linguistic services due to federal financing cuts.
Hernán Treviño, spokesperson for the Department of Public Health of the County of Fresno, said that the county had reduced the number of community health workers by more than half, from 49 to 20 positions. This has reduced the availability of field browsers who speak Spanish, Hmong or Aboriginal languages in Latin America and help immigrants register for health plans and plan routine screening.
Treviño said that staff are still available to support residents in Spanish, Hmong, Lao and Punjabi in the county offices. A free telephone line is also available to help residents access services in their favorite language.
Mary Anne Foo, Executive Director of Orange County Asian and Pacific Islander Community Alliance, said the Federal Substance Abuse and Mental Health Services Administration had frozen $ 394,000 in a two -year contract to improve mental health services. Consequently, the alliance plans to release 27 of its 62 bilingual therapists, psychiatrists and case managers. The organization serves more than 80,000 patients who speak more than 20 languages.
“We cannot keep them until June 30,” said Foo. “We always try to understand it – if we can cover people.”
Orozco Rodriguez reported to Elko, Nevada.
This article was produced by Kff Health Newspublishing California Healthlinean editorially independent service of California Health Care Foundation.
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