it requires almost everyone under age 65 to have an jergens either from their employer or from medicaid or private insurance. and if they don't have this they will have to buy at and that is employer coverage on medicaid and that will effectively estimate up to 60 million people and they have to start getting insurance starting at 18 months in january 2014. there's been a lot of talk about subsidies but how much will it really cost? so the kaiser family foundation has a wonderful subsidy calculator where again the year just estimates and projections based on data from the congressional budget office. the report to the 45-year-old head of household with an income of about $46,000 a year will pay $2,600 a year for insurance in 2014 and puts subsidized and have maximum out-of-pocket costs of more than $4,000. the with the subsidies are structured the benefits are different a 60 year old person earning $48,000 a year will pay $10,000 for insurance in 2014. and plus out-of-pocket costs of to $6,000. i was surprised at how much. that's enormous. what is an exchange and how will it work? peopl