President Obama's health care law will be available in Spanish and other languages, according to new rules the administration issued late last week that tell the "navigators," who are supposed to help Americans negotiate the labyrinthian law, to be prepared to help non-English speakers.
The in-person assistants, who will help the uninsured determine the coverage and benefits they qualify for, have been told they'll have to assess the racial and ethnic groups in their regions, know those groups' preferred languages and "diverse cultural health beliefs," and be prepared to work within those constraints.
While illegal immigrants have been excluded from the Affordable Care Act, or "Obamacare," many legal immigrants will qualify, and the Obama administration is eager to make sure it reaches anyone who's eligible, as part of its goal of bringing down the ranks of the uninsured.
The navigator guidelines issued Friday apply to state-based insurance exchanges set up wholly or partially by the federal government. Those states that opted to run their own exchanges can choose whether to adopt the guidance.
But already, many state-based exchanges are translating materials and looking to navigators and in-person assistants (IPAs) to be prepared to help non-English speakers get enrolled.
Nevada, for example, wants 40 percent of the groups that offer in-person assistance to have at least one person conversant in Spanish, since 43 percent of Nevada's 577,000 uninsured residents are of Hispanic origin, said C.J. Bawden, a spokesman for the Silver State Health Insurance Exchange.
In New York, officials in Albany recently awarded $27 million in grants to individuals and community groups who, in 48 different languages, will connect qualified residents with benefits under the health care law.
And in the District of Columbia, Web and outreach materials will be available in Spanish and Amharic, the latter in recognition of the capital area's large Ethiopian population. The city's call center will accommodate questions from a much broader array of languages, officials said.
Officials from ProEnglish, a group that advocates for English to be the official language at all levels of government, said they would rather see the government push for non-English speakers to learn the language, rather than reach out to them in their own tongue.
"That way, they can educate themselves about these programs and fully understand what they are signing up for, rather than relying on these so-called 'navigator' groups who might have their own political agendas," said Suzanne Bibby, director of government relations for ProEnglish.
She said the group doesn't normally take a stance on topics like the health care law, but is "very concerned with the multilingual effort surrounding it."
States said they want to make sure they get the non-English advice right.
Mr. Bawden, the Nevada official, said his state is building a Spanish version of a Web portal from the ground up, rather than translating from English, where they feared something could be lost in translation.
While naturalized citizens are required to demonstrate they have a working knowledge of English, some are exempted, including older residents who have been in the country for a long time. Some of those are covered by Medicare, but others are not — leaving millions of Americans and legal permanent residents who may not be fluent in English but are eligible for benefits under the new law.
"Legal residents are eligible for enrollment in premium tax credits through the exchange, whether or not they speak English," said Timothy S. Jost, who has studied the health care law and is a professor at the Washington and Lee University School of Law. "This is only fair as most of them are working people paying taxes."
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