What to Know About Section
1557 and Language Access

Passed in 2010, the Affordable Care ACT (ACA) expanded healthcare access eligibility to include people previously without health insurance. Meeting three specific goals was the aim of this Act. Goal number 1 was to make affordable health insurance available to more people, goal number 2 was to expand the Medicaid program to cover people with income lower than 138% of the federal property level (FPL), and the last goal was to support certain innovative methods of medical care delivery designed to lower the costs of healthcare overall. Click here for more info on the ACA.

In this act, there is a nondiscrimination provision known as section 1557. Also called Health Care Rights Law, this section prohibits discrimination in healthcare based on factors such as race, age, disability, ethnicity, sex, language and more. One of the key components of section 1557 is language access.

If you want to understand section 1557 better to figure out if you’re being discriminated against, or, for example, to be sure you’re doing everything in accordance with the law, then here’s what we’re going to do. Below I’m going to list things you need to know about section 1557 and language access specifically. Once you’re done reading, you’ll have greater knowledge on this entire concept and what it entails.

Language Access Explained

As one of the key components of section 1557, language access serves to strengthen the protection of people with limited English proficiency, or LEP, by both restoring and expanding requirements for language services. Those language services are necessary because they facilitate the communication between people who don’t speak English well. As a health care provider, you’re obligated to help LEP individuals easily access health care, as well as participate in federal health programs. Both verbal interpreting and written translation is necessary to achieve that. This should help you understand the section better: HHS.gov.

There’ve Been Some Changes, But It Is Still in Effect

Some changes have been brought about in 2020 regarding language access, but section 1557 is still very much in effect. If you’re a covered provider, you are obligated to provide access to language services for those who need them. And those services have to be free of charge.

The New Rule Focuses on Groups Instead of Individuals

While the difference may seem subtle and almost insignificant, the new rule states that healthcare providers must provide meaningful access to their programs and activities for LEP individuals, as opposed to the old rule which stated that every organization had to provide meaningful access to a LEP individual who is eligible to be served or is likely to be encountered. If you don’t quite understand the difference here, that’s because it is rather subtle, but let me make it clear. Basically, under the new rule, the focus is shifted from individuals to LEP population.

There Is a Four-Factor Test to Check if a Covered Entity Is Compliant

If you’re unsure whether you’re compliant or not, there is, fortunately, a four-factor test adopted by the HHS, which you can use to check that. The test includes the following factors:

  • The number or the proportion of LEP individuals who are to be served or who are likely to be encountered.
  • The frequency of the LEP individuals being in contact with the entity’s programs
  • The nature and the importance of the programs
  • The resources the entity has available and the costs

Low Quality Interpreting and Translation Services Are Prohibited

While the new rule does indicate that audio is enough when it comes to remote interpreting services, i.e. that video isn’t necessary,  section 1557 language access clearly prohibits low quality interpreting and translation services. Using low quality interpreting services or relying on unqualified individuals when it comes to both interpreting and translating is strictly forbidden. To be compliant, you have to invest in quality and ensure meaningful access to all LEP individuals.

Another thing to know is that, if you’re already following the 2016 rule, then there is probably no need for you to change a thing, despite the changes that have been made to section 1557. Developing and implementing a language access plan, although it may not be necessary, is still encouraged and regarded as a good thing to do. If, however, you’re a new organization who wants to be compliant, it’s best to check all the rules in detail and ensure you’re providing LEP individuals with meaningful language access.