The Limited English Proficient Population: Describing Medicare, Medicaid, and Dual Beneficiaries

Purpose: The Limited English Proficient (LEP) population experiences well-documented suboptimal health outcomes and substandard provider experiences. The lack of national estimates on the size of the LEP population relative to the healthcare setting makes examining health outcomes for this population very difficult. This analysis addresses this limitation by publishing population estimates for LEP persons enrolled in Medicare, Medicaid, and Duals (enrolled in Medicare and Medicaid). Focusing on the Medicare and Medicaid programs provides an important foundation as these programs are not only the largest insurers in the United States but are also governed by legislation that requires LEP persons to receive equitable access to care. Methods: Data from the 2014 American Community Survey Public Use Microdata Sample (ACS PUMS) were used to produce national estimates and measures of statistical accuracy for the LEP population enrolled in Medicare and/or Medicaid (LEPMM). Results: In 2014, there were approximately 8.7 million LEP persons enrolled in Medicare, Medicaid, or both programs (Duals). The LEPMM was concentrated along the western and eastern coastlines and the southwestern region, with California and New York each containing more than 1 million LEPMMs. The LEPMM was also highly diverse with varying disability status, and most were racial or ethnic minorities and elderly. Conclusion: These findings provide a foundation for measuring an understudied and at-risk population that will enable population health professionals to develop effective culturally and linguistically, and appropriate services and policies that address health disparities in the LEPMM.