Speech-sign or "bimodal" bilingualism is exceptional because distinct modalities allow for simultaneous production of two languages. We investigated the ramifications of this phenomenon for models of language production by eliciting language mixing from eleven hearing native users of American Sign Language (ASL) and English. Instead of switching between languages, bilinguals frequently produced code-blends (simultaneously produced English words and ASL signs). Code-blends resembled co-speech gesture with respect to synchronous vocal-manual timing and semantic equivalence. When ASL was the Matrix Language, no single-word code-blends were observed, suggesting stronger inhibition of English than ASL for these proficient bilinguals. We propose a model that accounts for similarities between co-speech gesture and code-blending and assumes interactions between ASL and English Formulators. The findings constrain language production models by demonstrating the possibility of simultaneously selecting two lexical representations (but not two propositions) for linguistic expression and by suggesting that lexical suppression is computationally more costly than lexical selection.