Federal health care reforms have led to the creation of a government agency in Kentucky comparable in staffing to the secretary of state's office, with 30 employees. But it also has scores of contract workers and an annual budget more than 10 times larger, at $39.5 million. The Kentucky Health Benefits Exchange will help more than 600,000 uninsured residents arrange coverage under the Affordable Care Act.
State officials say they'll do it on the cheap, compared with what states that opted to be part of a federally operated insurance exchange will pay. The federal government is proposing a 3.5 percent fee on insurance premiums to operate exchanges for states that didn't create their own, while Kentucky is proposing the existing 1 percent fee on insurance.