(The featured image contains work of an employee of the Executive Office of the President of the United States, taken or made as part of that person’s official duties. As a work of the U.S. federal government, it is in the public domain.)
On March 1st, 2025, President Trump issued Executive Order 14224, designating English as the official language of the United States and revoking Executive Order 13166, which had guided language access services since 2000. I recently participated in a webinar with language policy expert Dr. Bill Rivers to help healthcare providers navigate this evolving landscape. The overwhelming interest indicated the uncertainty this executive order has created.
Understanding Executive Orders vs. Laws
Executive orders direct how federal agencies implement and enforce existing laws, but they cannot overturn or replace the laws themselves. Only Congress has that power. While the President can change how federal agencies provide guidance or enforce compliance, he cannot unilaterally eliminate statutory rights established by Congress and upheld by the courts.
What Changed: Executive Orders and Implementation Guidance
For language access, the most significant change created by Executive Order 14224 is the formal revocation of Executive Order 13166, which previously directed federal agencies to provide guidance to federal fund recipients for language access services. The language access guidance that many of us have relied upon to build compliant services has been removed from government websites, and revised guidance has not yet been provided.
During the webinar, we discussed the immediate impact on federal agencies that enforce language access requirements:
- The Office of English Language Acquisition (OELA) has been effectively eliminated
- The Department of Education’s Office of Civil Rights has been reduced by 60%
- The Department of Homeland Security’s Office of Civil Rights has been eliminated
These changes have left many federally funded organizations confused about how to move forward.
What Hasn’t Changed: The Legal Foundation Remains Solid
To resolve this confusion, it’s helpful to remember the key point Dr. Rivers emphasized in our webinar: The fundamental legal requirements for language access remain firmly in place.
The executive order states that “nothing in this order requires or directs any change in the services provided by any agency”. It gives agency heads discretion to “make decisions as they deem necessary to fulfill their respective agencies’ mission.”
The revocation of Executive Order 13166 affects implementation guidance but does not change the underlying civil rights laws that require language access. Title VI of the Civil Rights Act of 1964 still prohibits discrimination based on national origin, which courts have consistently interpreted to require providing a language bridge in any program or activity receiving federal financial assistance.
For healthcare providers, Section 1557 of the Affordable Care Act still requires language assistance for LEP individuals. New regulations from the DHHS finalized in April 2024 strengthened these protections, requiring an annual Notice of Availability of language assistance services, clearer definitions of the requirements for qualified interpreters and translators, and human review of machine translation.
Language Access Under the Trump Admin
Disparate impact liability is a legal theory that recognizes that a policy or practice can be discriminatory even if it appears neutral on its face, when it disproportionately affects protected groups. Why do I bring this up?
Another new executive order signed in late April says the federal government will only act when it can prove someone meant to discriminate, not when a rule merely hurts certain groups more than others. That matters because many civil-rights cases—like those that require hospitals, schools, or police departments to offer interpreters or translated forms—are built on the idea that a “neutral” policy can still unfairly block people who don’t speak English well or who have disabilities. By telling agencies to drop this “disparate-impact” approach, they can effectively stop policing those hidden barriers based on that legal theory.
What does that mean on the ground? If this Executive Order stays in place, federal watchdogs will likely file far fewer complaints or investigations over missing language services, so families who need an interpreter may have to rely on state laws or take organizations to court themselves. Some protections, such as clear language-access rules in healthcare, still exist, but proving intentional discrimination is harder and costlier. In short, the federal safety net that quietly pushed institutions to accommodate people with limited English or disabilities just got thinner, and keeping those services in place will depend more on local rules, community pressure, and private lawsuits.
A Time of Transition
We’re in the very early stages of these policy changes. Their full impact will take time as legal challenges, agency interpretations, and implementation details evolve. During this transitional period, a prudent approach is maintaining existing language access programs that work well. As Dr. Rivers said, “keep on keeping on” with established best practices while staying informed about policy developments is a well-reasoned path forward.
5 Steps You Can Take
In that spirit, rather than reacting with alarm or making hasty changes to your language access program, consider these practical steps:
- Maintain Current Effective Practices: Don’t dismantle systems that are working well. The legal foundation for language access remains intact, and continuing your proven approaches ensures compliance and quality care.
- Review Your Documentation: Ensure your language access policies reference the relevant laws rather than Executive Order 13166. This grounds your practices in statutory requirements that remain in force.
- Focus on ROI Beyond Compliance: According to our recent survey, 58% of healthcare leaders expect an increase in demand for interpreting services in 2025, regardless of uncertainty in federal policy.
- Track Key Metrics for LEP Patients. Our survey found that 77% of healthcare organizations don’t measure quality outcomes specifically for LEP patient populations. Consider tracking the length of stay, readmission rates, and patient satisfaction scores of LEP patients. Compare the performance of this cohort to the rest of your patient population.
- Consider On-Demand Interpretation. These services can reliably connect you to professional interpreters for important conversations, like admission and discharge. They’re a flexible and cost-effective solution.
The ROI of Language Access Goes Beyond Compliance
- Interpreters help LEP patients go home from the hospital up to 2.5 days sooner, saving both hospitals and patients money while getting people back to their families faster.
- When hospitals use interpreters during admission and discharge, 63% fewer patients return unexpectedly. This avoids costly readmission penalties and spares patients the stress and disruption of returning to the hospital.
- Thanks to professional interpreters, patients who understand their care instructions feel less anxious and more in control. They’re also more likely to follow their treatment plans correctly, which prevents complications and additional visits that drive up costs.
Language access isn’t just good business, it’s good medicine and fundamental to compassionate, patient-centered care.
Confidence Amid Change
The current policy shift creates challenges, but the legal foundation for language access remains strong. By maintaining your commitment to serving LEP populations, you’re meeting legal requirements and delivering better care outcomes.
Dr. Rivers noted in our webinar, “The lack of funding doesn’t relieve civil rights obligations.” Healthcare organizations must continue prioritizing language access for compliance because it represents a sound investment in inclusive, value-based care delivery.
For a deeper dive into building a value-based case for language services beyond compliance, download our free eBook, “Bridging the Language Gap in Value-Based Care.” And if you missed our recent webinar on responding to these policy changes, you can access the recording to hear directly from our language access experts about navigating this evolving landscape.
