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Originally published in The Tennessean, February 2026

Tennesseans work hard for their health care coverage, and it’s a major expense for many of their employers. At BlueCross, our role is to slow rising health care costs so our neighbors can afford the care and coverage they need. But we’ve seen payments for medical and drug claims rise by 25% in just the past five years. 

BlueCross is a not-for-profit health plan with no owners and shareholders, and we’re just one of the many insurers Tennesseans can choose from. But this is our home state, so we believe it’s our responsibility to help people understand why health care and coverage costs what it does.  

Last year, we made changes to improve how we review the accuracy of claims, adjust payments for mid-level providers and lower lab and drug costs. But now, provider lobbying groups are pushing state legislation that would roll back our changes and add new mandates, making healthcare and insurance even more expensive. 

What these bills would mean for Tennesseans 

Senate Bill 2550 is a wide-ranging effort that would: 

• Eliminate claim accuracy reviews, making it harder to catch billing errors that drive up costs for employers and families, as described by Dr. J.B. Sobel. 

• Block the use of prior authorizations, which help keep care safe and appropriate. We only require them for around 3% of services and 5% of drugs, and focusing coverage on evidence-based care ensures responsible use of everyone’s premium dollars. 

• Prevent technology improvements that speed up claims approvals (we don’t use it to deny or adjust claims). 

These provisions would legally shield providers from any accountability for what they charge. 

For insured patients, that could mean more delays, less clarity, and higher costs added back into the system. 

Senate Bill 2155 is a broad proposal that would: 

• Require patients with insurance to pay the same rates to mid-level providers as they do to physicians with more advanced training. 

• Limit the ability to adjust payments based on quality, results, or how care is delivered, which are tools used today to help keep care affordable and accessible. 

• Slow down routine payment updates by requiring long notice periods and re-negotiations with tens of thousands of providers for changes our current contracts allow for. 

This bill would limit our ability to negotiate fair prices for care and could disrupt access to it. 

Instead of encouraging competition the way other markets do, this bill would legally lock in higher prices for everyone. 

Senate Bills 2574 and 2576 would: 

• Remove basic prescription safety checks based on clinical guidelines, including high-risk drugs like opioids. For example, Tennessee saw more than 1,300 fewer opioid overdose deaths in 2024, a roughly 30% decline that also outpaced other states. 

• Set higher drug prices in state law by requiring minimum reimbursements, instead of allowing prices to be negotiated for our customers. 

Simply put, these two bills take away safety checks and cost controls, forcing higher prices that are paid for by the people who buy coverage. 

The result could add $1.2 billion a year in drug costs for Tennessee families, businesses and taxpayers. 

There are also several proposed bills that mandate insurance coverage for certain screenings or treatments. Each of the proposals are for services with real value for many Tennesseans.  

The problem is mandates like these can require payment for services for anyone, without evidence they’d help based on the individual’s health status. That drives up costs for everyone since each member’s premium helps pay for other people’s care, too.   

Affordability depends on accountability 

Together, these bills would further strain Tennessee’s health care system. These costs would show up in premiums for families and the small businesses that drive our economy. 

These proposed laws are unlikely to improve health outcomes or increase access. But they do ask the government to use Tennessee law to raise costs by removing important checks and balances that protect the safety and financial wellbeing of our members.