With California at the forefront of the most comprehensive nationwide health care reform effort in half a century, it isn't affordability but language barriers that providers and legislators fear will prevent minorities from taking advantage of greater access to coverage.
The Affordable Care Act, which begins open enrollment in October and becomes effective Jan. 1, will make health insurance more accessible and affordable to millions of Americans who now lack insurance. But in California, where nearly 16 million people, or 43 percent, speak a language other than English — it's 45 percent in San Francisco — implementing the act presents a challenge.
At a panel discussion about this topic Wednesday, state Assemblyman Phil Ting, D-San Francisco, promoted Assembly Bill 1263, under which California would invest $200,000 to gain $270 million in federal funds authorized by the act to fund interpreter services for state Medicaid enrollees.
Interpreters are very often "our lifeline," Ting said, noting that many immigrant families are accustomed to having their children translate when they receive medical treatment.
The U.S. Department of Health and Human Services does not recommend using children as interpreters, especially because they often lack medical vocabulary, said panelist Annis Arthur, deputy regional manager for the department's Office for Civil Rights.
Legislation like AB 1263 would help break down language as the barrier to health care access, Ting said.
"We can't expect our children to be there," Ting said. "What kind of system will they be able to access? I don't want to hyperbolize, but in these situations it's a case of life or death."
Members of the Asian and Latino community helped put a human face on this issue at Wednesday's panel.
San Francisco resident Juan Situ shared how she waited hours for an interpreter to help her fill out forms for her sister's hospitalization, only for the situation to get no better after her procedure.
"After the surgery, the interpreter was gone and we wanted to ask the doctor why my sister was in so much pain," Situ said in Cantonese. "Finally, the doctor came to us but there was no interpreter, so we could not communicate."
Although California and the U.S. have great language access laws, lapses exist, said forum panelist Cary Sanders, director of policy analysis at the California Pan-Ethnic Health Network.
"Part of it is they are not aware they have the right to request language access," she said. "That is a huge issue. We heard a couple stories today but think of all the stories we are not hearing. The system fails and we don't know about it."