HHS’s Language Rule Excludes Millions of People

What would you think about a rule designed to give translation of important insurance documents to those who do not speak English well, if that rule required this service in nine counties in New Mexico, but excluded the entire City of Albuquerque?

Well that is exactly what a rule, about to be adopted by the Department of Health and Human Services will do.

What would you think of this rule if I told you that it excludes entirely a total of 28 states and the District of Columbia.? Well it does exactly that.

The rule’s official title is “Group Health Plans and Health Insurance Issuers: Rules Relating to Internal Claims and Appeals and External Review Processes.” This rule is to implement a provision of the Affordable Care Act that grants consumers the right to appeal a decision of their insurance company concerning coverage. Pretty important stuff.

The rule also deals with the requirement that communications with the consumers be done in a ‘culturally and linguistically appropriate manner.’ The rule implements this provision by requiring that insurance companies translate information about these important appeals rights for consumers who do not speak English well.

Here’s the catch: the insurance companies only have to do this if a language group composes 10% of a county’s population. As a consequence, not only are 28 states and the District of Columbia entirely excluded, so are huge urban populations that do not read English well and who will not understand their rights.

Here are a few other examples of how this thing works;

• In Northern California, Chinese speakers in San Francisco County will receive translated information about their rights to appeal insurance company decisions, but the 62,000 Spanish speakers residing in the same county will not receive them. Nor will these services be accorded to the nearly 98,000 Spanish speakers in nearby Alameda County, the 96,000 in Fresno County, or the 54,000 in San Mateo County.

• In Southern California, Spanish speakers in Los Angeles County will receive translation under this rule, but the 649,985 Asian and Pacific Island language speakers in the county will not.

• In New York, Spanish speakers in Queens and Bronx Counties will receive these services but the 252,000 Spanish speaking residents of Kings and Nassau counties will not, even though they live right next door to one another.

• In New Jersey, the Spanish speaking residents of Hudson, Passaic, and Union Counties will be provided translation services, but their 125,149 Spanish speaking neighbors in Bergen, Essex, and Middlesex C ounties will not.

• In Illinois, the 110,211 Spanish speakers in Kane County will receive translation services while the 649,985 in nearby Chicago will not.

This rule simply does not work and should not be adopted. Contact HHS Secretary Sibelius and ask her not to finalize these rules.

Here’s the list of excluded states:

Alabama, Connecticut, Delaware, District of Columbia, Hawaii, Indiana, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, West Virginia, Wisconsin, Wyoming.

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