How English as the Official Language Impacts Healthcare Access and Equity

The Implications of EO 14224: A Step Towards Monolingualism?

On March 1, 2025, an unprecedented executive order was signed by President Trump, designating English as the official language of the United States. Dubbed Executive Order 14224, this directive not only highlights a significant shift in national policy but also underscores potential implications for health care access among individuals with limited English proficiency (LEP). More than 27 million individuals across the nation, particularly among Hispanic and Asian communities, face unique barriers when navigating the health care system. By limiting access to resources in multiple languages, EO 14224 threatens to exacerbate existing health disparities.

Historical Context: Previous Policies Supporting Language Access

Historically, language access in the U.S. has been supported by a variety of laws designed to empower individuals who do not speak English fluently. The Civil Rights Act of 1964 and Section 1557 of the Affordable Care Act (ACA) have long been instrumental in providing protections against discrimination based on national origin and have mandated that federally funded entities offer multilingual health services. However, Executive Order 14224 effectively revokes these protections by allowing federal agencies to scale back their multilingual services and prioritize English-only communication.

Health Consequences: The Healthcare Divide

The decline of multilingual services poses alarming consequences for those with LEP, who already encounter significant challenges in accessing quality health care. Due to miscommunication and misunderstanding, patients with LEP are at increased risk for adverse health outcomes. Research has demonstrated that one-fifth of adults with LEP have faced negative experiences when seeking health care, highlighting the existing barriers individuals in this demographic must navigate.

Economic Impact: The Case of Limited-English-Proficient Workers

EO 14224 could also have economic ramifications for limited-English-proficient workers. A study published in the Journal of Labor Economics revealed that similar official English laws previously led to a reduction in earnings for limited-English-proficient individuals. The fear is that employers may seize upon this opportunity to adopt workplace English-only policies, inadvertently marginalizing non-English speaking workers further.

Potential Benefits of Language Access: Moving Towards an Inclusive Society

The importance of maintaining and enhancing language access services cannot be overstated. Studies show that when health care entities comply with language access requirements, patients report higher satisfaction rates and better health outcomes. An inclusive approach could foster a healthier, more integrated society that recognizes the diverse backgrounds of its members, enhancing community overall health and wellness.

Future Predictions: Need for Advocacy and Reform

As we approach a new era under EO 14224, the need for advocacy surrounding language access has never been more pressing. The possibility exists for grassroots movements to emerge, advocating for the rights of individuals with LEP and pushing for the reinstatement of essential language access policies. Stakeholders including healthcare providers, non-profits, and community organizations must unite to ensure equitable access to healthcare services for all.

In conclusion, while the decision to designate English as the official language of the United States may stem from a desire for unity, the ramifications for health and economic equity are profound. It is essential for professionals in health, wellness, and policy fields to engage with this issue to protect the rights and health of millions of Americans.

Call to Action: Health professionals and community advocates must remain vigilant and proactive in educating themselves and others about the importance of language access. Join advocacy efforts to support the reinstatement of equitable health policies that cater to the needs of individuals with limited English proficiency.