Currently, the SPEAK Act mandates the Department of Health and Human Services (HHS) to develop standard guidance regarding language access for telehealth technology in consultation with industry stakeholders like “language service companies,” interpreting/translation professional associations, and LEP patient advocates, among others.
Specifically, the Act requires HHS to “issue and disseminate” guidance on best practices for five key areas of healthcare telecommunications as they relate to LEP patients. These areas include:
- Integrating interpreters into telehealth interactions
- “Providing accessible instructions” for accessing telehealth platforms
- Making digital patient portals more LEP accessible
- Integrating platforms for multi-party calls to facilitate video-remote interpreting
- Providing multilingual textual materials, such as “text message appointment reminders and prescription information”
Bill Rivers, the government affairs advisor for the ALC, is quoted in the ALC press release as saying, “because our industry will be part of the consultative process to develop this guidance, we have the opportunity to help shape how language access should be provided in telemedicine.”
Buried in a Much Larger Bill
The passage of the SPEAK Act under the Trump administration may come as a surprise, considering the president’s March 2025 executive order (EO) declaring English the official language of the United States, and subsequent actions rolling back federal support for language access. These include, for example, Attorney General Pam Bondi’s memo about phasing out “unnecessary multilingual offerings” from federal agencies.
However, the SPEAK Act did not actually make it to the president’s desk as a stand-alone bill. In fact, at the time of writing, the Congress webpage for the bill shows no new action since it was referred to committee in March 2025.
Instead, the substantive text of the SPEAK Act was included as “section 6213” in a massive and contentious appropriations bill titled “Consolidated Appropriations Act, 2026,” which allocated funds for several federal agencies (H.R.7148).
The appropriations bill was signed into law by the US president on February 3, 2026, but before reaching his desk, the final version narrowly passed the House of Representatives in a 217-214 vote to approve amendments added by the Senate. The president’s subsequent signing of the bill approved funding for affected federal agencies and ended a partial government shutdown that began at the end of January 2026.
Broadly speaking, the SPEAK Act could be described as a “rider” attached to the Consolidated Appropriations Act, a relatively common strategy used by members of Congress where they manage to pass a piece of policy-making legislation by tacking it onto a larger appropriations bill. It was included in the version of the appropriations bill introduced before the House of Representatives on January 20, 2026.
Per the text of section 6213, the HHS will have one year to issue its guidance on best practices for improving LEP access to telehealth services.
