Recent federal funding cuts and staffing reductions have reduced the availability of staff interpreters working for nonprofits, according to a 2025 study by the Kaiser Family Foundation (KFF). Dozens of nonprofit language access positions have been eliminated through systemic cuts to overall agency and nonprofit budgets. In addition, hospitals and other health care providers face staff and program cutbacks because of federal funding terminations. The status of HHS funding remains unclear because of several pending lawsuits. Funds have been partially restored and some staff rehired for some HHS-funding supported organizations but the restorations are more at random than an across the board resumption of federal funds uniformly throughout the country.
According to KFF:
“[T]he eliminated positions include “community workers who help non-English speakers sign up for insurance coverage and navigate the health care system.. Policy and funding changes could leave some without lifesaving care, particularly children and seniors. People are going to have a hard time accessing benefits they’re entitled to and need to live independently, said Carol Wong, a senior rights attorney for Justice in Aging, a national advocacy group.
Nearly 69 million people in the U.S. speak a language other than English, and 26 million of them speak English less than “very well,” according to the most recent U.S. Census data available, from 2023. A KFF-Los Angeles Times survey from that year found that immigrants with limited English proficiency reported more barriers accessing health care and worse health than English-proficient immigrants. Health advocates fear that, without adequate support, millions of people in the U.S. with limited English proficiency will be more likely to experience medical errors, misdiagnosis, neglect, and other adverse outcomes.”
Research during the COVID pandemic graphically revealed how poor or non-existent language services negatively impact people’s lives:
AS KFF details:
“During the start of the pandemic in 2020, ProPublica reported that a woman with coronavirus symptoms died in Brooklyn after missing out on timely treatment because emergency room staffers could not communicate with her in Hungarian. And, at the height of the crisis, The Virginian-Pilot first reported that a Spanish translation on a state website erroneously stated that the covid-19 vaccine was not necessary.
Research shows language assistance results in higher patient satisfaction, as well as fewer medical errors, misdiagnoses, and adverse health outcomes. Language services also save the health care system money by reducing hospital stays and readmissions.”
On March 1, the president issued an executive order that declared English as the official language of the United States:
“To promote unity, cultivate a shared American culture for all citizens, ensure consistency in government operations, and create a pathway to civic engagement, it is in America’s best interest for the Federal Government to designate one — and only one — official language. Establishing English as the official language will not only streamline communication but also reinforce shared national values, and create a more cohesive and efficient society. Accordingly, this order designates English as the official language of the United States.”
The executive order is not a law and has no legal effect. Instead, the order is more symbolic than legally binding. At a minimum, the March 1 executive order fosters a societal dynamic that LEP people and immigrants, regardless of immigration status, are unwelcome in this country.
[The March 1] order left the decision whether or not to provide language access] to each federal agency and whether to maintain or adopt a new language policy. Some have already scaled back: The Department of Homeland Security and the Social Security Administration reportedly reduced language services, and the Justice Department says it is reviewing guidance materials.
Federal agencies are no longer required to provide language services. However, the same discretion is not available to federal funding recipients, such as hospitals, social agencies, and public schools. The federal law of language access continues to apply fully to them. Confirming the state of language access law after the March 1 executive order, the Justice Department recently stated in a March 21 Federal Register announcement:
“Continuing Obligation All recipients of Department financial assistance have a continuing obligation to comply with Title VI, all applicable Title VI implementing regulations, all applicable federal civil rights laws and nondiscrimination provisions. Recipients of federal financial assistance also have a continuing obligation under the Rehabilitation Act of 1973 to ensure that their communications with individuals with disabilities are as effective as communications with others and may need to provide qualified sign language interpreters for individuals who are deaf. Recipients of federal financial assistance, including subrecipients, are reminded that the denial of language assistance services can be evidence of discrimination on the basis of national origin or disability under certain circumstances.”
Despite the March 1 executive order, language access mandates continue, as KFF emphasized:
“Insurers still need to include multi-language taglines in their correspondence to enrollees explaining how they can access language services. And health facilities must post visible notices informing patients about language assistance services and guarantee certified and qualified interpreters.”
Recent and ongoing federal policy changes have also resulted in much uncertainty, disquiet, and fear. These changes, such as increased immigration enforcement, large federal school funding reductions, and the president’s declaration of English as the official language of the United States have all intimidated many people, influencing them to maintain lower profiles in their daily lives, resulting in:
“[P]eople with limited English proficiency have scaled back their requests for language services, which health care advocates attribute in part to President Donald Trump’s immigration crackdown and his executive order declaring English as the national language.
Such policy and funding changes could leave some without lifesaving care, particularly children and seniors. “People are going to have a hard time accessing benefits they’re entitled to and need to live independently,” said Carol Wong, a senior rights attorney for Justice in Aging, a national advocacy group.”
As KFF explains, the overall situation remains in flux. Some staff and funds have been restored but largely at lower levels than in 2024. While federal funds remain uncertain, the need for language access is not uncertain, remaining remains as powerful as ever. Witness these poignant accounts from KFF:
“Hernán Treviño, a spokesperson for the Fresno County Department of Public Health, said the county cut the number of community health workers by more than half, from 49 to 20 positions. That reduced the availability of on-the-ground navigators who speak Spanish, Hmong, or Indigenous languages from Latin America and help immigrants enroll in health plans and schedule routine screenings.
Treviño said staffers are still available to support residents in Spanish, Hmong, Lao, and Punjabi at county offices. A free phone line is also available to help residents access services in their preferred language.
Mary Anne Foo, executive director of the Orange County Asian and Pacific Islander Community Alliance, said the federal Substance Abuse and Mental Health Services Administration froze $394,000 left in a two-year contract to improve mental health services. As a result, the alliance is planning to let go 27 of its 62 bilingual therapists, psychiatrists, and case managers. The organization serves more than 80,000 patients who speak over 20 languages.
We can only keep them through June 30,” Foo said. “We’re still trying to figure it out — if we can cover people.”
© Bruce L. Adelson 2025 All Rights Reserved The material herein is educational and informational only. No legal advice is intended or conveyed.
Bruce L. Adelson, Esq., is nationally recognized for his compliance expertise. Mr. Adelson is a former U.S Department of Justice Civil Rights Division Senior Trial Attorney. Mr. Adelson is a faculty member at the Georgetown University School of Medicine and University of Pittsburgh School of Law where he teaches organizational culture, implicit bias, cultural and civil rights awareness.
Mr. Adelson’s blogs are a Bromberg exclusive.