WASHINGTON -- As right-leaning states such as Texas and Florida redouble their opposition to President Obama’s healthcare law in the wake of last month’s Supreme Court decision, Kentucky is joining the list of states that will establish its own insurance exchange in 2014, implementing a central pillar of the Affordable Care Act.

Gov. Steven L. Beshear, a Democrat, formally told Health and Human Services Secretary Kathleen Sebelius on Tuesday that he would sign an executive order to create an exchange “so Kentucky will be prepared to operate it.”

“Since the law was signed,” Beshear told Sebelius, “my administration has been contacted repeatedly by interest groups representing employers, health insurers, insurance agents, health care providers and healthcare advocates who have expressed that the Commonwealth should run its own exchange.”

These state-based exchanges will be the central Internet-based marketplace for consumers who do not get health benefits at work, allowing them to shop for insurance plans the way they shop for hotels or airline tickets. Those making less than four times the federal poverty line will be eligible for government subsidies.


By 2019, about 24 million Americans are expected to buy coverage on the exchanges.

The new healthcare law directs each state to set up its own exchange, but allows the federal government to step in and set up an exchange if a state fails to act. Many GOP governors and state lawmakers nationwide are resisting these exchanges to protest the new law.

Beshear’s letter makes Kentucky the 16thstate plus the District of Columbia to either have an insurance exchange, to have enacted legislation to create one or to have established one by executive order, according to a tally by the Kaiser Family Foundation.

These include California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New York, Oregon, Rhode Island, Vermont, Washington and West Virginia. Massachusetts and Utah already have exchanges that predate passage of the Affordable Care Act in 2010.


Six states -- Florida, Louisiana, Maine, New Hampshire, South Carolina and Texas -- have decided not to create an exchange, according to the Kaiser tally. Governors in New Jersey and New Mexico vetoed bills passed by the legislature to establish exchanges.

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