Individuals with limited English proficiency (LEP) do not speak English as their primary language and have a limited ability to read, write, speak, or understand English. In 2021, there were approximately 25.7 million people with LEP in the United States, including almost 4.9 million Medicaid and State Children’s Health Insurance Program (CHIP) enrollees. In the United States, having limited English proficiency is associated with disparities in both health outcomes and access to care. State Medicaid agencies are required to provide meaningful access for individuals with LEP, although the way in which states do so varies in part due to different state demographics and policy priorities.
This issue brief begins with an overview of the population with LEP and background on Medicaid requirements for making applications and communications accessible to those with LEP. It then describes the results of a MACPAC analysis of the availability of translated materials, including applications, renewal forms, and taglines. It finishes with a brief discussion of state experiences providing translated materials and interpretation services based on stakeholder interviews. MACPAC found that the availability of translated materials varied among states and document type, with paper applications being more likely to be translated into non-English languages than electronic application portals.
