The Role of Language in Health Care Access and Utilization for Insured Hispanic Adults

Language can play an important role in individuals’ access to and use of health care and impact their understanding of their health coverage and communications with their provider. The Affordable Care Act (ACA) coverage expansions may help mitigate barriers people with limited English proficiency (LEP) face in accessing coverage and care. However, individuals with LEP may still face increased challenges after gaining coverage. To better understand how health care experiences vary by language, this analysis examines differences between English- and Spanish-speaking Hispanic adults with insurance using data from the 2014 Kaiser Survey of Low-Income Americans and the ACA. The findings show that among insured Hispanic adults:

Demographics. Spanish-speakers are as likely as English-speakers to have a worker in the family but are lower income, older, and more likely to report an ongoing health condition than English-speakers.

Heath Plan Experiences. There are few differences between Spanish- and English-speakers in experiences choosing a plan, the likelihood of having problems with their plan paying for services, or experiencing difficulties interacting with their plan. However, Spanish-speakers give lower ratings to their plan, have more limited understanding of their coverage, and are more likely to have gaps in coverage for needed services than English-speakers.

Access and Utilization. There are no significant differences between Spanish- and English-speakers in their access to and use of care, although clinics play a significantly larger role as a source of care for Spanish-speakers. The majority of both groups report good communications with their provider.

Affordability. Reflecting their more limited incomes, Spanish-speakers are more likely than English-speakers to be concerned about their ability to afford health care. Further, although Spanish-speakers are less likely to have a premium, those who do are nearly twice as likely as English speakers to report difficulty paying it.

The findings show that, among insured Hispanic adults, Spanish-speakers face some increased challenges compared to English-speakers. They have greater gaps in their understanding of their coverage, and, as such, may benefit from targeted education efforts. Moreover, given their more limited incomes, affordability of coverage and care is particularly important for Spanish-speakers. Despite these challenges, Spanish-speakers are as likely as those who speak English to receive care and communicate well with their provider. These findings suggest that clinics, which most Spanish-speakers rely on as their usual source of care and have a longstanding role serving a diverse population, are likely effective in connecting them to care and ensuring good communication with patients.

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