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Loan Truong, left, who is Vietnamese, has blood drawn by Rechyle Torio, right, a phlebotomist, Friday, March 1, 2013 at International Community Health Services in Seattle. The clinic, which serves patients who speak more than 50 different languages, illustrates a challenge Washington state will face as it launches its new health insurance exchange as part of the federal Affordable Care Act. (AP Photo/Ted S. Warren)