Here is a closer look at what Thursday's ruling could mean for Kentuckians.
640,000, or 15 percent, of the state's residents are uninsured.
Kentucky has laid the groundwork for a statewide health insurance exchange.
But Governor Steve Beshear opted to wait for the supreme court ruling before doing anything more.
Beshear now says he will sign an executive order creating the state's health insurance exchange.
Exchanges primarily serve individuals buying insurance on their own and small businesses with up to 100 employees.