Tennessee residents shop for ACA health plans through HealthCare.gov, the federal marketplace, since the state runs no exchange of its own.
Tennessee has not adopted Medicaid expansion under the ACA. This leaves some low-income adults in a coverage gap, earning too little to qualify for marketplace premium tax credits but not fitting the state's traditional Medicaid eligibility categories, known locally as TennCare.
Because the coverage gap affects a real share of Tennessee's working-age population, residents near the lower end of the income scale should check subsidy eligibility carefully during enrollment rather than assuming they won't qualify for help. It's also worth comparing plan networks across the state's larger metro areas, Nashville, Memphis, and Knoxville, versus more rural counties, since choices can differ.