IMPACT IN TENNESSEE
683,000 -- Number of additional Tennesseans to gain health insurance
63,168 -- Number of Hamilton County residents who will pick up coverage
$3 billion -- Additional federal aid coming into Tennessee over 10 years
$1.2 billion -- Additional Medicaid expense for Tennessee between 2014 and 2019
1 million -- Estimated number of Tennesseans who will shift from employer plans to new exchanges by 2014.
Source: BlueCross BlueShield of Tennessee study on health care reform's effects in Tennessee
Health care reform will bring more money and health care coverage to Tennessee, but it will also mean longer lines and wait times for most people to see a doctor.
That's the conclusion of a study by Tennessee's biggest health insurer on the sweeping health care package adopted nearly two years ago and scheduled to be implemented over the next three years.
"Since the number of providers will not increase in the short run, there will be a strain on the system's ability to supply services," said Dr. Steve Coulter, president of the BlueCross-funded Tennessee Health Institute and author of the study of health care reform in the Volunteer State. "That may mean, generally speaking, worse access to services for those who are currently insured."
But while lines may be longer at physician offices and hospitals, more people will have access to such services. The BlueCross study estimates that 683,000 more Tennesseans, including 63,168 in Hamilton County, will gain health insurance by 2014 under the so-called "Obamacare" plan.
As a relatively poor state, Tennessee also will gain $3 billion more in federal assistance than what the state will pay in taxes for the expanded Medicaid program and federal aid to new health exchanges.
Expanding Medicaid will cost the state of Tennessee an extra $200 million a year from 2014 to 2019. But Coulter said that represents only 1 percent of the state's budget "and shouldn't have a dramatic impact on overall spending" by Tennessee government.
But U.S. Sen. Lamar Alexander, R-Tenn., contends that the extra Medicaid costs for the state of Tennessee will crowd out needed investments in education and other state programs.
At a Senate Appropriations Committee meeting this week, Alexander tried unsuccessfully to push through legislation to require a new estimate of the cost to states of expanding Medicaid benefits.
"Our public universities in America are in grave danger of losing their quality and stature at a time when our nation needs them to help create jobs, and this is directly related to federally mandated health care costs," said Alexander, a former Tennessee governor and president of the University of Tennessee.
Craig Becker, president of the Tennessee Hospital Association, said Friday he "shares the concern over the lack of primary care" providers to see the extra insured persons.
"We will be looking to increase the number of primary care givers -- physicians, nurse practitioners, physician assistants -- to meet the increase demand," he said.
But Coulter said boosting the supply of trained doctors, nurses and other health care providers will take years.
Proponents of health care reform dismiss such criticisms, contending that many employers will save money on health care spending and the extra billions of dollars in federal aid will stimulate growth and tax collection.
Tony Garr, policy director for the Tennessee Health Care Campaign which backed health care reform, said the plan will be "a gift" for Tennessee with substantial benefits for the state.
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Garr said when TennCare was developed to expand Medicaid coverage in 1994, there were similar worries about too many patients taxing the health care system and extending wait times at doctors' offices.
"Well, that did not happen," he said, citing a recent University of Tennessee survey which found that TennCare recipients "see physicians more often, visit emergency rooms less for routine care, and are able to see a physician without excessive travel or waiting time."