Beshear's letter bucks a trend of solidly red states rejecting the
Affordable Care Act. Some conservative governors have staunchly refused
to set up exchanges, even though that decision ultimately gives the
federal government more power over their states' healthcare systems.
HHS must certify by next year that states are ready to set up the new marketplaces, which will be operational in 2014. HHS will run a federally administered fallback in states that can't or won't meet the deadline for setting up their own exchanges.