Steel Introduces Bipartisan Bill to Increase Health Care Language Access and Reduce Costs
Today, Rep. Michelle Steel (R-CA) introduced the Supporting Patient Education and Knowledge (SPEAK) Act of 2023 to require Secretary of Health and Human Services Xavior Becerra to create a task force with stakeholders dedicated to improving language access in health care for Americans with limited English proficiency. The task force would develop recommendations and best practices for addressing barriers for people with limited English proficiency which would lead to improved patient outcomes and reduced associated costs.
Rep. Steel was joined by Reps. Jimmy Gomez (D-CA), Juan Ciscomani (R-AZ), Adriano Espaillat (D-NY), Tony Cardenas (D-CA), Monica De La Cruz (R-TX), Young Kim (R-CA), Lou Correa (D-CA), Henry Cuellar (D-TX), Juan Vargas (D-CA), Salud Carbajal (D-CA), Susie Lee (D-NV), and Judy Chu (D-CA).
“California’s 45th district is home to nearly 40% Asian Americans, many of which English is their second language,” said Steel. “As the daughter of a non-English speaking immigrant, I understand the need for an increase in translation options, especially in health care. Patients with limited English are at greater risk for medical errors and $1.7 billion in medical malpractice costs over five years could have been avoided with better patient communication. I am proud to lead the charge to help make it easier for all Americans to access health care services.”
"I represent a majority Spanish-speaking district, where many of my constituents may face barriers when accessing telehealth resources and other health care information technology. I believe that this task force will work to provide solutions to break down the language barrier in the Health Care Services Industry. With bipartisan effort, this is an issue that my colleagues and I can work to resolve," said De La Cruz.
“Despite the rapid expansion of telehealth in recent years and its potential to lower health care costs and improve patient outcomes, individuals and families with limited English proficiency face significant barriers to access these online services,” said Chu. “To help close the digital divide, I'm excited to collaborate on the SPEAK Act so that we can convene government, stakeholders, and health care workers and amplify the best telehealth care practices.”
“Language barriers should never deter someone from accessing health care,” said Ciscomani. “This bill spurs HHS to identify ways we can ensure that patients with limited English proficiency have the same understanding and receive the same quality of care as their counterparts.”
“No one should have to encounter language barriers when pursuing information about their health and well-being, particularly in a country as culturally and ethnically diverse as the United States,” said Gomez. “With nearly 350 languages spoken across the country, we have a collective responsibility to provide culturally accessible care. I’m proud to introduce this bill with Congresswoman Steel to expand language access, modernize our health care system, and underscore the idea that health care must be accessible to all who call our country home.”
“Access to health care remains a challenge for many underserved communities today, and limited language diversity in our systems only adds an additional barrier,” said Cárdenas. “The SPEAK Act is a bipartisan, common-sense solution that will improve access to critical health tools and technologies. By convening a task force to determine best practices to make health technologies more usable for the 25 million non-English speakers in the U.S., we will be able to maximize access to essential services like telehealth and patient portals and improve the quality of life for those we represent.”
“Language barriers should not prevent people from receiving the healthcare they rightfully deserve," said Vargas. "I am proud to support Rep. Steel’s bipartisan legislation to develop recommendations and best practices for patients seeking to navigate language differences in our healthcare system.”
Industry Support
The legislation is supported by: National Immigration Law Center (NILC), American Medical Association (AMA), Healthcare Leadership Council (HLC), Healthcare Information and Management Systems Society (HIMSS), America's Essential Hospitals, LIBRE Initiative, Justice in Aging, California Medical Association, Association of Language Companies, National Health Law Program, American Academy of Family Physicians, Connected Health Initiative (CHI), American Heart Association, UnidosUS, American Psychiatric Association, American Translators Association, and Transcarent.
“Rep. Steel's SPEAK Act would identify the barriers and challenges that must be addressed in order to improve telehealth services for the over 25 million Americans with limited English proficiency. Many, including those in our own families, try to navigate our complex Health care system and often find themselves unable to engage with our system effectively. Understanding what can be done to increase access will enable additional telehealth use and lead to better health outcomes. The LIBRE Initiative applauds Rep Steel's efforts to improve language access so that all Americans can experience the benefits of telehealth and be empowered to have the health care choice that best fits their needs,” said Isabel Soto, Policy Director for The LIBRE Initiative.
“All of us, no matter where we were born, deserve equitable access to the benefits of virtual health care. Telehealth has increasingly served as a lifeline for people to access health care, but this crucial service is currently out of reach for so many people with limited English proficiency. By addressing gaps in the use of telehealth, we can improve health outcomes and lower costs for families. We thank Rep. Michelle Steel for introducing the SPEAK Act of 2023 and urge Congress to swiftly pass this important bill,” said Kica Matos, president of the National Immigration Law Center.
"As the use of telehealth has increased, those who speak languages other than English can be left behind without the same ease of access to virtual healthcare services. This disparity can and should be overcome, and the SPEAK Act intends to do just that with the creation of a task force to assess the current barriers and develop recommendations. The Healthcare Leadership Council welcomes this legislation, a positive step in improving health equity in this nation,” said Mary R. Grealy, president of the Healthcare Leadership Council.
Background
Over 25 million people in the United States have limited English proficiency (LEP). While the country has experienced an increase in the use of telehealth, people with LEP face barriers to accessing virtual health services. This hurts patients’ health and leads to higher system costs.
In February 2021, a doctor tried to help a family with LEP via a telehealth appointment. However, the father and daughter spoke a dialect that he could not obtain an interpreter for.
Due to the lack of effective communication, the doctor was unable to give a correct diagnosis, and five days later the daughter came into the emergency department with septic shock and a burst appendix. This tragedy could have been avoided with better coordination and resources.
Adults with LEP have 20% lower odds of having telemedicine visits than adults with English proficiency. Telehealth services are used less by Spanish-speaking patients, leading to lower patients satisfaction. A secret shopper study found that Spanish-speaking patients find it harder to schedule telehealth appointments at safety-net clinics. Providers are responsible for ensuring people with LEP have meaningful access to their telehealth platforms yet surveyed medical students reported inadequate training.