Language Challenge: Selling Health Insurance to 2.6 Million Californians

To reach the thousands of newly insured people who don't speak English, Kaiser Permanente, WellPoint and others rely increasingly on cultural competence in a variety of languages.

Understanding the 2,000-plus page Affordable Care Act (ACA) is daunting for anyone. Imagine the challenges faced by insurers and states with potential clients who have language barriers. In California, where Blacks, Latinos and Asians are 60 percent of the population and 75 percent of uninsured people, language skills and cultural competence are critical.


A joint study by the California Pan-Ethnic Health Network, the UCLA Center for Health Policy Research and the UC Berkeley Labor Center found that two-thirds of the estimated 2.6 million adults who will become eligible for federal subsidies in California's health-insurance exchange are Black, Latino or Asian, and 36 percent of those currently uninsured and expected to be covered under ACA have limited English proficiency.

While the ACA mandates that health plans be translated into appropriate languages in areas where 10 percent or more of the population speaks a language other than English, the bigger challenge is getting culturally competent information out to explain the new rules.

California is one of 18 states setting up its own health exchange to help newly insured people compare and purchase health-insurance plans. The remaining states will default to the Federal Health Exchange.

The California exchange chose its name—Covered California—because it translates well into several of California's commonly spoken languages. The organization's website has a Spanish version as well as one in 11 other languages, including Farsi, Khmer, Lao, Russian and Tagalog. The site contains clear information about what is covered and includes definitions of new healthcare terminology.

Consumers may well choose a health insurer based on the resources insurers can share about how patients will be cared for in a culturally competent manner under each insurer's plan. WellPoint's Anthem Blue Cross (WellPoint is No. 34 on The DiversityInc Top 50 Companies for Diversity list) and Kaiser Permanente (No. 3 on the DiversityInc Top 50) are among the four largest insurers of the approximately 30 that will be offered by Covered California. WellPoint offers services in five languages  and has an online Spanish video that introduces members to its most popular programs. Anthem has produced a cultural-competence resource for physicians and healthcare professionals that is intended to help reduce health disparities caused by a lack of culturally or linguistically competent care. The new toolkit is available on a website dedicated to cultural and linguistic competency.

Kaiser Permanente has a link on its website to numerous in-language plan materials and just released a Spanish version of its healthcare-reform website. Kaiser, which provides healthcare as well as health insurance, also has a National Linguistic & Cultural Programs department that develop strategies to ensure meaningful access to healthcare and services for people with limited English. Kaiser presented its program to train and use staff members as bilingual translators and its Diversity and Health Video Series, a cultural-competence training tool, at a recent DiversityInc Innovation Fest!

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