According to estimates based on the most recent U. S. census data, 4% of the population of Hamilton County, where median household income is $46,505, qualifies for government assistance in paying for health insurance premiums under the new health reform.

However, the figure is closer to 55% of the population who could obtain subsidies or credits to buy insurance in Walker County, Ga., where median household income is $39,123.

Local health providers and consumers are still trying to get a clue of real-life effects of health care reform. The expansion of government programs such as Medicaid can provide some hint of what the insurance landscape will appear to be in the year 2014. It will be indicated that who will decide to buy coverage with the help of subsidies and who will have to pay a penalty by forgoing coverage.

According to the new health care reform law, Barack Obama allows individuals and small businesses to team together to buy insurance at better rates via state-run insurance exchanges. These exchanges will face federal guidelines on coverage levels and premium rates.

Dr. Vince Viscomi, a local pulmonologist and past President of the Chattanooga and Hamilton County Medical Society said, “If you work at McDonald's and make $8 an hour, you'll be OK because you'll have almost a full subsidy to buy insurance. But if you (are paid) more, you are penalized for it by having a smaller subsidy. And that hurts”.