Economic Policy


Limited English Proficient Communities Remain At-Risk for being Uninsured

A new report from the Robert Wood Johnson Foundation provides state-level estimates for health insurance status among Limited English proficient (LEP) communities. Using data from the 2012 American Community Survey, the report‘s authors examined data for LEP people aged 5 years and older (e.g., did not speak English very well). Being LEP is common among the insured population, with at least 30 states and the District of Columbia having 10% of its state populations as LEP; California, New Jersey, and New York have nearly one-third of its uninsured population aged 5 and older as LEP.

Report findings indicate that a significant portion of the LEP population remains un- or under-insured. Among the estimated 24.5 million LEP population (approximately 8.6% of the total population aged 5 and above), more than 1/3 were uninsured (9.5 million). Approximately 7.3 million of the LEP population have employer-sponsored insurance, yet this population comprises of only 4.5% of the total population aged 5 and older with employer-sponsored insurance. Close to 2 million people with LEP purchased insurance directly from an insurer, but this population comprises only 5% of the total population that purchased insurance directly in the individual market. Finally, at least 12% of the Medicaid population aged 5 and above are LEP, with 13 states having a Medicaid LEP population exceeding 10% and two states exceeding 20%).

The authors also highlight that LEP uninsured communities are at higher risk of not enrolling in public insurance or marketplace plans due to limited information provided for recent and undocumented immigrants. Furthermore, many LEP individuals that are uninsured remain at risk of not receiving appropriate in-language services and medical care. Thus, recommendations for health plans, providers, and policy makers include ensuring language assistance services that improve access to care for un and under-insured LEP populations.

Joanne Chan, Joint Center Graduate Scholar, Harvard School of Public Health.