OAKLAND -- Set on a gritty corner of Oakland's International Boulevard, the nonprofit Street Level Health Project offers free checkups to patients who speak a total of 22 languages, from recent Mongolian immigrants seeking a doctor to Burmese refugees needing a dental exam.

It also opens a window on one of the challenges for state leaders who are trying to implement the Affordable Care Act, President Barack Obama's sweeping health care overhaul.

Understanding the law and its possibilities for ordinary citizens is a task even for politicians and bureaucrats, but delivering its message to non-English speakers who can benefit from it is shaping up as a special complication. That is especially true in places

Chan Lai Ly has his feet examined as part of a regular check-up related to his diabetes, by Honghue Duong, a physician's assistant, Friday, March 1, 2013 at International Community Health Services in Seattle. (AP Photo/Ted S. Warren) (Ted S. Warren)

Even deciding what to call a health insurance program generates angst in a polyglot state. California's health-care insurance marketplace staff is testing "Covered California."

That would be "California Cubierto" in Spanish, but "what does it mean?" asked Laura Lopez, the Street Level clinic's executive director.

But the main feature of health care reform -- the state's health insurance exchange opening next year -- will require consumers to contrast and compare the features and costs of a range of private health insurance policies to select the one most

That could be a tall task for native English speakers, but more so for residents who speak English "less than very well."

Zaya Jaden, a 35-year-old from Mongolia visiting the Oakland clinic, said she would not know how to translate it into her native language. Advocacy groups say the state should translate it into Arabic, Armenian, Chinese (Mandarin and Cantonese), Farsi (Persian), Hmong, Khmer (Cambodian), Korean, Russian, Tagalog and Vietnamese.

Jaden was in the clinic getting free care for her sister's migraine, a much higher priority than considering how the expansion of the nation's social safety net through the Affordable Care Act might benefit her.

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Health care reform opportunities a challenge for highly diverse population with many languages