The U.S. Department of Health and Human Services on Dec. 10 said it has given tentative approval to applications filed by six states to launch health insurance exchanges in 2014 in which the uninsured, among others, can obtain coverage.
Those six states are Colorado, Connecticut, Maryland, Massachusetts, Oregon and Washington.
More state approvals will be announced in the weeks and months ahead, said HHS officials.
The HHS announcement coincided with Tennessee Gov. Bill Haslam informing federal health care reform regulators on Dec. 10 that Tennessee will not set up a health care exchange.
"In weighing all of the information we currently have, I informed the federal government today that Tennessee will not run a state-based exchange. If conditions warrant in the future and it makes sense at a later date for Tennessee to run the exchange, we would consider that as an option at the appropriate time," Haslam said in a statement.
Other states that also have said they will not set up exchanges include Arizona, Florida, South Dakota and Texas.
Under the Patient Protection and Affordable Care Act, which authorized the exchanges, the federal government can set up exchanges in states that decline to do so.
States have until Dec. 13 to notify the federal government of whether they will set up exchanges.
A lawsuit filed this year in federal court by Oklahoma Attorney General Scott Pruitt contends that premium subsidies authorized by the reform law and available, starting in 2014, to the uninsured can only be used to buy coverage through state exchanges.