Trump Administration’s roll-back of a civil rights rule leads to life-threatening
barriers for low-income older adults with limited English proficiency
seeking health care during the pandemic
Washington, DC (February 5, 2021) — People with Limited English Proficiency (LEP) have a right to language assistance services when they visit a health care provider. Language assistance ensures they understand the medical information and instructions they receive. Not knowing about this right means not knowing to ask for those services, not receiving them, or having to rely on informal, unqualified interpreters like a family member. Even before the pandemic, data showed that LEP patients report lower quality care and experience more medical errors than English-speaking patients. Language barriers exacerbate existing health disparities in communities of color and immigrant communities—some of the very same communities most at risk of contracting and dying from COVID-19. Yet in the waning days of the Trump Administration, the federal government actually eliminated protections for LEP individuals in health care.
Today, Justice in Aging and the Center for Medicare Advocacy, along with pro bono firm Stinson LLP, filed a lawsuit against the Department of Health and Human Services (HHS) in U.S. District Court for the District of Columbia on behalf of Chinatown Service Center and St Barnabas Senior Services, two Los Angeles area community-based organizations that provide social services to LEP older adults.
There are more than 6.5 million people over 60 in the United States who are LEP. Plaintiffs assist older LEP clients in navigating the health care system and interpreting important documents from health care providers, among other services. As a large number of LEP older adults attempt to access health care during the pandemic, they are left to rely solely on community-based organizations because the Trump Administration eliminated these important language access requirements in health care. These organizations have seen a surge in demand for help interpreting information and, most recently, booking vaccine appointments, leading to longer wait times for other critical services they provide their clients including nutrition, transportation for preventive and routine care, and help applying for housing vouchers.
“The older adults we serve at St. Barnabas Senior Services (SBSS) are typically in their mid-70s, and live alone, are low income, have comorbidities, and speak minimal English. Since January, when the COVID-19 vaccine first became available to people over 65, our limited English proficient clients have relied on us to help them with something as critical as setting up an appointment because of language barriers. By virtue of age, race, and economic status, they are among the groups hardest hit by the virus. It’s unjust that those most at risk during this deadly pandemic are experiencing entirely preventable barriers when accessing healthcare simply because the Trump Administration eviscerated their language access protections,” said Rigo Saborio, President and CEO of SBSS.
“At Chinatown Service Center (CSC), our mission is to provide assistance to those who are underserved by the system. Older adults with limited English Proficiency are a large part of our client base. The rollback of language access protections during the COVID-19 pandemic has created a surge in demand for language assistance services such that our caseload doubled during the final four months of 2020 compared to 2019,” said Peter Ng, Chief Executive Officer of CSC.
“The Trump Administration’s rollback of these protections during the COVID-19 pandemic is particularly harmful to older adults accessing healthcare. As they seek vaccinations from this deadly virus, those who are limited English proficient are left to navigate an entire system with inadequate language access protections,” said Denny Chan, Senior Staff Attorney at Justice in Aging.
“Understanding your doctor and important medical documents can be the difference between getting the health care you need and not even knowing you need health care, especially for older adults. There is no justification for the elimination of these important civil rights protections,” said Alice Bers, Litigation Director at the Center for Medicare Advocacy.
“It is unconscionable that, in the midst of a global pandemic, Health & Human Services has taken steps to limit the health care access of more than 6.5 million LEP individuals in the United States. Studies show that communication and language barriers are linked to a diminished quality of care, worse clinical outcomes, longer hospital stays, and higher rates of hospital readmissions. Particularly at a time when hospital beds and medical resources are so precious, we must do everything we can to reduce communication and language barriers so LEP individuals receive the quality of care that they deserve,” said Harvey Reiter, Partner at Stinson LLP.
The lawsuit alleges that Health & Human Services failed to follow the Administrative Procedure Act when it rolled back language access protections that were put in place as part of the Health Care Rights Law (or Section 1557) of the Affordable Care Act (ACA). The protections are meant to target health disparities by requiring health plans and other entities to inform patients both of their right to interpretation, and their right to legally challenge discrimination based on language ability. But in 2020, the Trump Administration issued a rule that rolled back language access protections in the regulation (as well as many others affecting LGBTQ people, immigrants, and women). Today, the plaintiffs are asking the Court to vacate the 2020 rule and enjoin its implementation.