According to economists, one big factor is ObamaCare:

Aaron Yelowitz, an economics professor in the business college, told attendees that another concern for Kentucky is the effect of the Affordable Care Act in 2014. The federal law will require businesses with 50 or more employees to provide "affordable" insurance to full-time workers or pay a tax penalty of $2,000 for each employee.

Using a detailed econometric model, Yelowitz estimated that 283,549 of 2.4 million Kentucky workers could be affected. Analyzing by industry, Yelowitz estimated that workers in the administrative, waste management, manufacturing, mining and transportation sectors might be most affected.

The region most likely to be affected is in southeastern Kentucky, although all areas of the state would have a number of businesses that will need to respond to the health care mandate.

Kentucky, of course, doesn't have to create an ObamaCare health insurance exchange. Lawmakers have an opportunity to display their opposition to the law and avoid some of the law's impact by refusing to allow the exchange to come into existence.