The Spanish Constitution of 1978 and the Statute of Autonomy of the Balearic Islands of 1983 established the official nature of both Spanish and Catalan and entrusted public authorities with guaranteeing the right of citizens to use one or the other on an equal footing. Subsequent to the language legislation of 1986, the legal framework of Catalan has varied depending on the majority party that forms a government. The debate stirred up by these regulations demonstrates the difficulties in ensuring real equality between official languages, when social initiatives cannot translate into sufficient political support and the national political context is hostile. The article explores this debate and discusses recent regulations surrounding the official languages competencies of health system staff, from the direct experience of the authors, as members of two consultative institutions on legal and sociolinguistic matters.