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In this June 7, 2013, file photo, President Barack Obama talks about the Affordable Care Act in San Jose, Calif. State officials and health care advocates were gearing up for the launch of the federally run online insurance marketplace where residents can shop for health coverage from private insurers on Tuesday, Oct. 1, 2013. Under President Barack Obama's health law, almost all Americans will be required to have health insurance starting next year, and the online marketplaces opening Oct. 1 were a hallmark of the legislation.

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