Health care coverage: language access.

Garcia’s measure would require health care service plans and health insurers to provide meaningful access to language assistance for every individual with limited English proficiency and their companions who are eligible to receive services or are likely to be directly affected by the plans’ programs and activities. It would mandate offering a qualified interpreter or using a qualified translator whenever interpretation or translation services are required, and it would prohibit requiring a person with limited English proficiency to pay for their own interpreter. The act also addresses remote interpreting and establishes administrative penalties for violations.

Key mechanisms center on ensuring language access throughout enrollment, service delivery, and communications. Plans and insurers would be required to assess linguistic needs and translate vital documents into top languages determined by enrollment size, with specific thresholds guiding the number of languages to translate. Vital documents to be translated include applications, consent forms, notices about eligibility and participation, notices of denial or termination of services, and rights to file grievances or appeals; translated explanations of benefits are limited to instances where a response by the enrollee is required. For nonstandard documents containing enrollee- or insured-specific information, notices about the availability of interpretation services would accompany the documents, and enrollees could request translations within a defined period. The bill also allows sight translation for expedited grievance or appeal processes and requires notices of language access and nondiscrimination to be provided in non-English languages, with accessibility expanded to marketing materials and communications related to costs and payments.

Additional provisions govern notices, reporting, and governance. Covered entities must inform enrollees, applicants, and the public about language assistance services and auxiliary aids in top languages, and must place this information in conspicuous locations both physically and online. Language access information is mandated to be integrated into many routine communications, including privacy notices, enrollment and termination materials, and cost disclosures. The act requires internal policies and procedures related to language access to be reported to the regulating department, along with staff training, recruitment and retention efforts, and the designation of a language access coordinator. Plans and providers would be subject to enforcement action and penalties for noncompliance, with defined definitions of qualified interpreters, translators, and related terms. The proposal envisions ongoing public input, biennial reporting, and a path for phased implementation, while noting alignment considerations with existing state programs and Medi-Cal standards.