[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-305332-105":53,"doc-detail-305332-en":127},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":120,"head_meta":122,"extra_data":124,"updated_unix":126},105,"en","enrollment-and-access-barriers-for-people-with-limited-english-proficiency","Enrollment and Access Barriers for People with Limited English Proficiency","","Overview of limited English proficiency (LEP) among Medicaid and CHIP populations and the policy context requiring meaningful language access. Summarizes disparities in health outcomes and care access for individuals with LEP, including reduced preventive services and difficulties understanding care information. Describes typical state language assistance approaches, with emphasis on translated materials and interpretation services, and outlines a MACPAC analysis of availability of translated applications and renewal forms, followed by insights from stakeholder interviews about state experiences.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":11,"@type":70,"position":76},"https://docshare.wps.com/template/presentations/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/enrollment-and-access-barriers-for-people-with-limited-english-proficiency/305332/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/enrollment-and-access-barriers-for-people-with-limited-english-proficiency/305332.png","ImageObject",442,249,{"name":88,"@type":89},"Mason","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-14","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",8,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"How is limited English proficiency (LEP) defined in the brief?","Question",{"text":109,"@type":110},"LEP refers to individuals who do not speak English as their primary language and have a limited ability to read, write, speak, or understand English.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What disparities are associated with LEP in health and care access?",{"text":114,"@type":110},"People with LEP report poorer health outcomes and face barriers to accessing medical care, preventive screenings, and usual health care providers. They are also more likely to struggle with understanding information about their care.",{"name":116,"@type":107,"acceptedAnswer":117},"What language assistance services do states most commonly provide for Medicaid and CHIP?",{"text":118,"@type":110},"The most common services include written translations of materials and oral interpretation services, provided in-person and telephonically via language lines.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},305332,1791730683,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":8,"category_name":11,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":8,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":79},5909887256941,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","July 2024 Advising Congress on Medicaid and CHIP Policy  \nEnrollment and Access Barriers for People with Limited English Proficiency  \nIndividuals 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 (OCR 2013) . In 2021, there were approximately 25.7 million people with LEP in the United States, including almost 4.9 million (19 percent) Medicaid and State Children’s Health Insurance Program (CHIP) enrollees (SHADAC n.d. ) . In 2019, 23 percent of children enrolled in Medicaid had a parent that spoke English less than very well (Haldar et al. 2022) .  \nIn the United States, having limited English proficiency is associated with disparities in both health outcomes and access to care. People with LEP report poorer health and worse health outcomes, such as lower rates of glycemic control, higher rates of uncontrolled asthma, and higher odds of poorly controlled hypertension (Kim et al. 2017, Fernandez et al. 2011, Wisnivesky et al. 2009, Ponce et al. 2006) . Individuals with LEP are also less likely to access medical care, have preventative screenings, or have a usual health care provider (Uscher-Pines et al. 2023, Sifuentes et al. 2020, Kim et al. 2011, Jacobs et al. 2005) . These individuals are also more likely to face difficulties in understanding information about their care compared to proficient English speakers (Wilson et al. 2005) .  \nState 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. The most common language assistance services are written translations of materials and oral interpretation services (in-person and telephonically via language lines) .  \nThis 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 (Appendix A) . 1 It finishes with a brief discussion of state experiences providing translated materials and interpretation services based on stakeholder interviews.  \nBackground  \nIndividuals with LEP come from varied racial and ethnic backgrounds, speak diverse first languages, and live in geographically diverse regions of the country. The percentage of Medicaid and CHIP enrollees who are limited English proficient varies widely by state; ranging from about 6 percent in Montana, North Dakota, and Utah to more than 30 percent in Massachusetts, West Virginia, Vermont, and New York in 2021 (Figure 1) (SHADACn.d. ) . In 2019, most individuals with LEP were Hispanic (70 .4 percent) or Asian (16 .1 percent) (Figure 2) . While many languages are spoken by individuals with LEP, the most common are Spanish (71 .4 percent), followed by Vietnamese (3 .2 percent), Chinese (3 .0 percent), and Arabic (2 .3 percent) . However, the number of people speaking these languages varies by and within states (Haldar et al. 2022) . For example, in all but four states (Alaska, Hawaii, Maine, and Vermont) , Spanish is the most commonly spoken non-English language (OCR 2017) .  \nFIGURE 1. Percentage of Medicaid and CHIP Population that is Limited English Proficient by State, 2021  \nNotes: Rates of Medicaid and State Children’s Health Insurance Program coverage by English proficiency for the noninstitutionalized population 5 years and over. Limited English proficient is defined as speaking English less than 'very well.'English proficient includes people who speak English only or speak English 'very well.'  \nSource: SHADAC analysis of the American Community Survey (ACS) Public Use Microdata Sample (PUMS) files (SHADACn.d. ) .  \nFIGURE 2. Percent of Nonelderly Adults in Medicaid Households Who are Limited English Proficient by","cbCailKKb2PgzBz5","https://ap.wps.com/l/cbCailKKb2PgzBz5","pdf",467445,"English","# Background\n## LEP demographics and languages across states\n## Health and access disparities\n# Medicaid language access requirements\n## Common language assistance services\n# Issue brief structure and analysis\n## MACPAC translated materials review (Appendix A)\n## Stakeholder interviews and state experiences","[{\"question\":\"How is limited English proficiency (LEP) defined in the brief?\",\"answer\":\"LEP refers to individuals who do not speak English as their primary language and have a limited ability to read, write, speak, or understand English.\"},{\"question\":\"What disparities are associated with LEP in health and care access?\",\"answer\":\"People with LEP report poorer health outcomes and face barriers to accessing medical care, preventive screenings, and usual health care providers. They are also more likely to struggle with understanding information about their care.\"},{\"question\":\"What language assistance services do states most commonly provide for Medicaid and CHIP?\",\"answer\":\"The most common services include written translations of materials and oral interpretation services, provided in-person and telephonically via language lines.\"}]","Enrollment and Access Barriers for People with Limited English Proficiency | PDF",1789823849]