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NASHVILLE - A new analysis warns that 161,650 low-income, adult Tennesseans risk disappearing into a health "coverage gap" when the federal Affordable Care Act largely takes effect on Jan. 1.

The Kaiser Family Foundation's report says two factors are at play: Tennessee has yet to agree to expand its Medicaid program under Obamacare, which the law originally mandated for states but now makes voluntary under a U.S. Supreme Court ruling.

Meanwhile, these poorer men and women don't qualify for financial assistance to buy private health insurance in the new online marketplaces known as exchanges.

Tennessee is one of 26 states, many of them with Republican governors, who have refused to go along with the Medicaid expansion, at least for now.

Republican Gov. Bill Haslam said he is still hoping to get the Obama administration to go along with his proposed "Tennessee Plan" on the expansion. It calls for the state to buy Medicaid-eligible Tennesseans' way onto insurance exchanges.

But Haslam also wants to exclude them from traditional Medicaid rules and require higher copays, which federal officials have balked at doing.

Earlier this week, Haslam told reporters while discussions on his expansion proposal are continuing there's been "nothing new" in terms of progress.

Further discussions with the administration has "obviously been a little bit inhibited" by the ongoing federal government shutdown as well as the rocky roll out of the exchanges, Haslam said.

Moreover, the governor revealed, federal officials are also questioning the state over its plan to get health providers to cut their costs for care.

"I wouldn't declare it dead at all," Haslam said.