(Pittsburgh) -- Pennsylvania could face cultural and linguistic challenges in trying to implement the Affordable Care Act when it comes to residents who speak limited English. 

The U.S. Census Bureau says about 1.1 million Pennsylvania residents spoke a language other than English at home between 2007 and 2011. That's about 9.5 percent of the population. 

Dozens of groups say they speak English less than very well. The largest group is about 196,000 Spanish speakers. Chinese is a distant second at about 36,000 speakers, followed by about 29,500 speakers of German and related languages, 23,600 speaking Vietnamese and 17,400 speaking Russian.

Patricia Documet of the Center for Health Equity at the University of Pittsburgh says the law won't cause major changes in delivering health care to those who don't speak English.