Governor Bill Haslam announced Tennessee will not create a state-run health insurance exchange.
Haslam said he was unsettled by the lack of guidelines from the federal government about insurance requirements under President Barack Obama's health care overhaul.
Exchanges are new online markets where costumers will be able to buy individual private policies. They can also apply for government subsidies to help pay their premiums.
About 30 million people around the country are expected to gain coverage under the law.
Tennessee has around 982,000 uninsured people.