For Kentucky as a whole, the negative impact is similar but larger — jacked-up costs, decreased worker productivity, lower quality of life, depressed school attendance and a poor image.

The Affordable Care Act will address these weaknesses.

Some 308,000 of Kentucky’s uninsured — mostly the working poor — will be covered when we increase Medicaid eligibility guidelines to 138 percent of the federal poverty level.

PricewaterhouseCoopers and the Urban Studies Institute at the University of Louisville concluded that expanding Medicaid would inject $15.6 billion into Kentucky’s economy over the next eight years, create almost 17,000 new jobs, have an $802.4 million positive budget impact (by transferring certain expenditures from the state to the federal government, among other things), protect hospitals from cuts in indigent care funding and shield businesses from up to $48 million in annual penalties.

In short, we couldn’t afford not to do it.

The other 332,000 uninsured Kentuckians will be able to access affordable coverage — most with a discount — through the Health Benefit Exchange, the online insurance marketplace we named Kynect: Kentucky’s Healthcare Connection.

Kentucky is the only Southern state both expanding Medicaid and operating a state-based exchange, and we remain on target to meet the Oct. 1 deadline to open Kynect with the support of a call center that is providing some 100 jobs. Having been the first state-based exchange to complete the readiness review with the United States Department of Health and Human Services, we hope to become the first one to be certified.

Frankly, we can’t implement the Affordable Care Act fast enough.

As for naysayers, I’m offended by their partisan gamesmanship, as they continue to pour time, money and energy into overturning or defunding the Affordable Care Act. It’s shameful that these critics haven’t invested that same level of energy into trying to improve the health of our citizens.

They insist that the Affordable Care Act will never work — when in fact a similar approach put into effect in Massachusetts by Mitt Romney, then the governor, is working.