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Contact: lppipress@luskin.ucla.edu

New UCLA LPPI Research Identifies Significant Barriers to Medicaid Access for
Non-English Speakers in Major U.S. Cities

LOS ANGELES (October 2, 2024) – The UCLA Latino Policy and Politics Institute today released a policy report examining the challenges faced by Spanish and Chinese speakers in accessing Medicaid through Managed Care Organizations (MCOs) in three major U.S. metropolitan areas: Los Angeles, Houston, and New York. The new research highlights significant disparities and offers actionable recommendations to improve health care access for Limited English Proficient populations.

The study – authored by Dr. Arturo Vargas Bustamante, Dr. Lucía Félix Beltrán, Rosario Majano, Dr. Esmeralda Melgoza, Ahmad Ismail, and Dr. Silvia R. González – utilized public data from the American Community Survey, online provider directories of MCO health plans and the Health Resources & Services Administration. It used georeferencing methods to map bilingual health care providers with a concentration of Limited English Proficiency populations whose primary language is Chinese or Spanish. In addition, the authors analyzed how state differences in Medicaid eligibility criteria impact access to health care. The findings show that Limited English Proficient individuals face unique challenges due to the uneven distribution of bilingual providers and significant overlap of foreign-born Latino populations with medically underserved areas.

The key findings of the report are:

• States with inclusive health policies provide better access to Medicaid for Limited English Proficient individuals. However, restrictive states leave significant gaps, impacting the health care access of these communities.
• The limited clustering of Spanish- and Chinese-speaking providers in specific areas fails to meet the widespread needs of the Limited English Proficiency populations studied.
• Nationwide, over 25 million individuals are identified as having Limited English Proficiency, representing about 8% of the U.S. population. Despite federal guidelines, there is significant variation in how states support these individuals in accessing health care.

“Our research underscores a critical gap in health equity, revealing that while Medicaid aims to serve as a safety net, not all communities are equally supported,” said Dr. Félix Beltrán. “This situation calls for a concerted effort to enhance language-specific services within Medicaid MCOs to ensure that all members of our community can receive the care they deserve.”

Based on their findings, the authors provide the following policy recommendations to reduce barriers to accessing high-quality care for Limited English Proficient adults with Medicaid-managed care:

• Expand Medicaid coverage under the Affordable Care Act to include all low-income adults and specifically target expansions to cover immigrant communities.
• Enhance linguistic and translation services across all stages of health care access, not just during clinical interactions.
• Improve data collection on primary language and Limited English Proficiency to enable targeted health care interventions.

“Access to health care is a fundamental right, yet our research shows that the current system often fails some of our most underserved populations,” said Dr. Bustamante. “By expanding Medicaid and improving linguistic services, we can make a substantial difference in access to quality care. It’s not just about health care; it’s about equity and ensuring everyone has the opportunity to lead a healthy life.”

This policy report urges state policymakers and health care providers to consider these disparities as they reform policies to create a more inclusive and equitable system. Read the report here.

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About UCLA Latino Policy and Politics Institute
The UCLA Latino Policy and Politics Institute is a non-partisan research institute that seeks to
inform, engage, and empower Latinos through innovative research and policy analysis. LPPI
aims to promote equitable and inclusive policies that address the needs of the Latino community
and advance social justice. latino.ucla.edu.