Summary

Q: What is the primary purpose of the Language Access for All Act? It seeks to codify language access protections into permanent federal law, preventing future executive orders from dismantling mandates for multilingual services and AI human-review.

Q: How does the SPEAK Act improve telehealth for multilingual patients? It requires HHS to create standardized best practices for integrating interpreters, multi-person video calls, and multilingual patient portals into virtual healthcare delivery.

Q: What is the timeline for the SPEAK Act’s implementation? The Act was signed into law on February 3, 2026. HHS has until February 2027 to publish final guidance for healthcare providers and platforms.

Two Bills Enshrine Language Access Into Law

For the 25 million Americans with limited English proficiency, 2025 and 2026 have brought both crisis and opportunity. As federal language access protections came under unprecedented attack, two pieces of legislation emerged that could fundamentally reshape how government and healthcare serve multilingual communities.

The Language Access for All Act and the SPEAK Act represent different strategies for the same goal: ensuring that language is never a barrier to essential services. One fights to preserve foundational civil rights protections. The other has already become law, focusing on a specific but critical gap in healthcare delivery. Together, they could offer a blueprint for language access in America.

The Language Access for All Act: Codifying What Executive Orders Cannot

Introduced in January 2026 as H.R. 7223, the Language Access for All Act emerged as a direct response to a March 2025 executive order that declared English the official language of the federal government and dismantled existing language access mandates.

The bill seeks to do something previous administrations accomplished through executive action: transform the protections of the Clinton Administration’s Executive Order 13166 into permanent federal law that cannot be revoked by future  orders. 

Key provisions of the Language Access for All Act include:

• Mandatory language access plans that federal agencies must develop, publish, and regularly update to provide services in the most commonly spoken languages
• Professional standards requiring agencies to use qualified interpreters and translators rather than untrained staff or family members for critical communications
• Human-AI balance that acknowledges translation technology while prohibiting agencies from fully replacing human linguists with AI; all AI-translated content must be reviewed by qualified human translators
• Public accountability mechanisms including a formal complaint system to track when individuals are denied meaningful access due to language barriers
• Telehealth integration for bringing qualified medical interpreters into virtual appointments
• Platform accessibility ensuring login instructions and patient portals function in multiple languages
• Multilingual communications standardizing non-English appointment reminders and prescription information
• Video technology standards enabling secure three-way calls between doctors, patients, and remote interpreters

The bill remains in committee review as of February 2026. It faces significant headwinds in a divided Congress. But its supporters argue that codifying these protections is the only way to ensure they survive changing political challenges.

Civil rights organizations and language services professionals have rallied behind the legislation, recognizing that executive orders—however well-intentioned—are inherently vulnerable. The act would make language access a statutory right, not an administrative courtesy.

The SPEAK Act: From Bill to Law in One Year

While the Language Access for All Act fights for its future, the Supporting Patient Education and Knowledge Act has already crossed the finish line.

Originally introduced as standalone legislation (H.R. 2092) in March 2025 by Rep. Monica De La Cruz (R-TX), the SPEAK Act's provisions were incorporated into the Consolidated Appropriations Act, 2026, and signed into law on February 3, 2026.

The act addresses a stark reality: telehealth has revolutionized healthcare delivery, but not equally. Studies show that adults with limited English proficiency are 20 percent less likely to use telehealth than English speakers. This is a digital divide with serious health consequences.

The SPEAK Act requires the Department of Health and Human Services to develop standardized guidance and best practices covering:

What made the SPEAK Act successful where other language access measures have stalled? Its focus on health outcomes and government efficiency transcended partisan divides. Language barriers in medicine lead to medication errors, higher hospital readmission rates, and longer recovery times. These problems increase healthcare costs for everyone.

Next Steps in the Regulatory Process

With the SPEAK Act now law, the work shifts from passage to implementation. HHS has until February 2027 to publish final guidance, and the community has a critical window to shape what that guidance looks like.

• Monitor FederalRegister.gov for notices from HHS or the Office for Civil Rights regarding telehealth language access guidance
• Submit real-world data and case studies directly to the HHS Office for Civil Rights, which enforces Title VI language access requirements
• Provide concrete examples of telehealth failures and successes, patient no-show rates for non-English speakers, and technical barriers in current video platforms

Meanwhile, the Language Access for All Act needs grassroots support to move forward. The bill requires congressional co-sponsors and public pressure to advance through committee. To take action, contact your member of Congress and ask them to co-sponsor H.R. 7223. Find your representative here.