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This paper examines the implementation of language-in-healthcare policy in a highly bilingual, medically stressed border region of south Texas. In its current form, federal language-in-healthcare policy unevenly impacts different geographic regions. Healthcare markets along the U.S.-Mexico border are particularly taxed by the recent language access mandates. This geographic inequality results in the absence of professional medical interpreters and in an exclusive reliance on local interaction patterns characteristic of the border bilingual region in the provision of language assistance services. Through in-depth interviews with 34 limited English proficient patients suffering from chronic diseases, this paper describes the impact of local interaction patterns on the provision of language assistance services for Spanish-speaking patients. It is argued that the routine enactment of these interaction patterns engenders restrictions on access to health information for limited English proficient Latino patients. It is further argued that the propagation of health information gaps contributes to unequal care and negative health outcomes for Spanish-speaking patients in the U.S. healthcare system.
