A study by Blue Cross Blue Shield of Tennessee takes an in-depth assessment of the possible effects that national health care reform could mean for Tennessee residents. The study estimates that 683,000 Tennesseans will get new Tennessee health insurance coverage under health care reform. It also focuses on possible changes in access to medical care, as well as the shift from employer-provided TN health insurance to the state exchange.Dr. Steven Coulter, president of the Tennessee Health Institute, conducted the study entitled “National Health Care Reform: The Impact On Tennessee.” According to Coulter, the study explores how the expansion of Medicaid and the establishment of the TN health insurance exchange in 2014 will affect the residents of Tennessee.Coulter says that since the advent of Medicare in 1965, the Patient Protect and Affordable Care Act has been the largest expansion of entitlement programs. “With the expected increase in consumers eligible for Medicaid expansion coverage and an estimated 1.5 million qualifying for subsidies in 2014, there is a great deal that needs to be addressed to ensure a smooth transaction,” he says. Coutler also noted that people who already have access to health care might have to wait longer when more people can afford to see a doctor unless there are basic changes to the health care system.What’s Happening With The Shortage Of Doctors In Tennessee?Long before health care reform, an appalling shortage of doctors was noted in Tennessee, and the situation has improved dramatically in some counties. On October 26, 2011, The Jackson Sun reported that the situation had improved in rural West Tennessee. Specifically, the doctor-patient ratio in Hardeman County went from one doctor per 4,675 people to one doctor per 2,229 people from 1992 to 1999. Chester County saw similar improvement with the ratio of one doctor per to 6,409 people falling to one doctor per 2,505 people.What’s Happening to Tennessee Health Insurance Prices?Coulter also notes the possibility that young adults will have to pay more for Tennessee health insurance by 2014. That’s because health care reform tends to level the playing field, so to speak. Groups, like the long living, have been paying high premiums, while young people have been paying low premiums. To average out the price of TN health coverage for all residents, some will likely end up paying more, but those who have been paying high rates, will get a break.Who Stands To Gain The Most From Health Care Reform?Overall, the people with the greatest economical disadvantages stand to benefit most as access to health care is extended to more state citizens. People who have been barred from getting TN health care coverage based on medical conditions will also get greater access to health care when they can finally get coverage.Employers are also expected to have financial gains when they can encourage employees to get Tennessee health insurance through the exchange because not providing coverage will improve the company’s bottom line.Will Everyone Directly Benefit From Health Care Reform?It remains to be seen whether people who currently have TN health insurance will have longer wait times for health care, with more doctors and clinics coming to the state. For example, a federally-funded clinic opened in Hardeman county in 1993 and in Hardin county in 1995. In East Jackson, West Tennessee Healthcare opened a clinic in 1996, and federally-funded clinics have been operating in Fayette and Lake County since the 1970s.Tennessee health insurance companies will have to navigate new price regulations and could see their profit margins decreasing over time. Insurers selling individual TN health insurance plans are already required to spend 80 percent of the premiums they take in to pay for policyholders’ care. That reduces the amount of premiums they have been permitted to keep as profit. Group plans have been managing regulations that require they spend 85 percent of premiums for policyholders’ care, though.