CHATTANOOGA, Tenn. — A research-based report from the newly established BlueCross BlueShield of Tennessee Health Institute takes an in-depth look at national health care reform’s possible positive and negative effects on Tennessee.

Noting that an estimated 683,000 Tennesseans will gain new coverage, the 38-page white paper focuses on potential resulting changes in access to services, including an inadequate supply of primary care; a shift from employer-provided insurance to exchanges; and an increase in state funding requirements.

The study entitled National Health Care Reform: The Impact on Tennessee was conducted and authored by Dr. Steven Coulter, president of the Tennessee Health Institute. Its purpose is to explore how the expansion of Medicaid and the creation of the health insurance exchange will impact Tennessee and its residents, and to help frame the issues that may need to be addressed by lawmakers, regulators, medical providers and businesses.

“The health care reform law represents the largest expansion of entitlement programs since Medicare was enacted in 1965,” said Coulter. “With an estimated 609,000 Tennesseans becoming eligible for Medicaid expansion coverage and an estimated 1.5 million qualifying for premium subsidies in 2014, there is a great deal that needs to be addressed to ensure a smooth transition.”

The report provides research based projections and analysis on the likely winners and losers of health care reform:


• The economically disadvantaged and/or those who have significant health care conditions who are not today covered will gain greater access to care.

• Some employers who shift their workers to the state based insurance exchange will likely experience an initial financial gain because their short term health care costs will be less than prior to reform.


• Those who currently have health insurance will likely experience longer wait times for care and find some of their costs increasing.

• Providers will find themselves in a market that has de facto price controls and will see their real dollar income drop over time.

This is the first report issued by the Tennessee Health Institute, which is designed to provide decision makers a fact-based, intellectual framework for public discussions on health care policy matters.

“The Health Institute is all about creating and expanding public discussions and dialogue about health care,” said Coulter, “because that’s what it’s going to take to improve the state of our health care system. Change and improvement start with conversation, and everyone must work together to advance the system and the health status of our fellow Tennesseans.”

Future research topics and presentations of the Tennessee Health Institute will focus on health care reimbursement variations, risk adjustment, prescription drug cost impacts, and issues and best-practice answers regarding the health status of the Volunteer State.

The report is available at

About BlueCross

BlueCross BlueShield of Tennessee's mission is to provide its customers and communities with peace of mind through affordable solutions for health and healing, life and living. Founded in 1945, the Chattanooga-based company is focused on reinventing the health plan for its 3 million members in Tennessee and across the country. Through its integrated health management approach, BlueCross provides patient-centric products and services that drive health improvement and positively impact health care quality and value. BlueCross BlueShield of Tennessee Inc. is an independent licensee of the BlueCross BlueShield Association. For more information, visit the company's website at