NASHVILLE, Tenn. — Tennessee’s 14 trauma centers are under increasing financial pressure, as they treat more patients each year while facing a steady decline in revenue from the state’s cigarette tax. Originally introduced in 2007 to help offset the costs of trauma care, the cigarette tax has become less reliable as cigarette sales have dwindled over the years.
During a Senate Finance, Ways, and Means Committee hearing on Tuesday, representatives from Tennessee’s trauma centers urged lawmakers to explore additional funding sources. Dr. Brad Dennis, trauma medical director at Vanderbilt University Medical Center, emphasized the growing gap in state trauma funding compared to neighboring states, which have more defined and effective funding models.
According to Dennis, states like Virginia generate about $16 million annually for trauma care by leveraging motor vehicle registration fees. In contrast, Tennessee’s cigarette tax revenue, which once brought in $9 million in 2008, had dropped to just $5.8 million in 2023, a significant shortfall for a system in high demand.
“As a physician, I’m glad fewer people are smoking. As a trauma physician, it hurts our resources,” said Dr. Reagan Bollig, a trauma physician at the University of Tennessee Medical Center in Knoxville. “It’s a dichotomy.”
Despite the drop in funding, trauma centers in Tennessee continue to face high operational costs. The state’s trauma centers require $170 million annually just to remain “ready” to treat patients, covering everything from medical supplies to staffing and infrastructure. However, the cigarette tax only covers 6.32% of this readiness cost, leaving the centers with a significant funding gap.
Tennessee’s per-resident contribution to trauma care is also among the lowest in the nation, at just $1.93 per person. By comparison, neighboring states provide as much as $8.12 per resident.
“We are not a profitable industry but a necessary one,” Dr. Dennis noted. “As you can imagine, there are many patients that are indigent or underfunded, so we need sufficient funding to maintain the care that is required.”
As the pressure on trauma centers grows, Tennessee lawmakers are facing tough decisions about how to support these critical services, which are vital to the health and safety of residents across the state. Without additional funding sources, Tennessee may struggle to keep pace with neighboring states and meet the growing demand for trauma care.
