ROCHESTER, N.Y. -- Stefan Glover of Canandaigua, N.Y., is 27 and in a vise. Worse, it's tightening.
First, he's paying off between $20,000 and $30,000 in college loans. "I'll be paying that off for a long time," he said, with a note of weary obligation in his voice.
Second, Glover bought a car on credit and he's paying that off, too. He has a job as a health trainer, but the difference between his income in that job and his debts is not something to inspire a sense of financial comfort.
That's not the tightening vise, though.
The vise is the mandate under the federal Affordable Care Act that he have health insurance by Jan. 1 or face a penalty. If he were under 26, he could go on his parents' health plan, if that were an option. But at age 27, he's on his own.
"My thing is that if it's something that will really put me under, I'm not going to do it," Glover said. "It depends on the kind of plans I can find and whether I can afford it along with everything else."
He's been researching his options, asking his dad and gathering data from the Internet. He knows there's a penalty if he goes without coverage but he's not sure of the amount.
Overall, he doesn't know at this point what he will do.
"I know how expensive health care can be," Glover said. "I had a car accident. When I realized my head was bleeding and I had to go to the hospital, the first thing I thought was that I didn't have health insurance. It was definitely a wake-up call."
Conversations with young people in the Rochester, N.Y., area, especially young men, revealed that many are aware of the law and the coverage requirement. Like Glover, they are examining the possibilities, including assessing the choices on the new health insurance exchange or marketplace.
They are looking for cheap plans - the monthly bite on their income from college loan repayments makes that essential - and they know in general terms how much a brief hospital stay or minor surgery costs.
Some young people haven't been following the issue and aren't aware of the coverage mandate.
Mike Singletary of Rochester is one of those. He is unemployed and without coverage. When told of the Jan. 1 deadline, he said, "This is the first time I've heard that."
Awareness of the law, and adherence to it, by this age cohort is critical to the success of the Affordable Care Act.
If insurers are to be able to cover millions of now-uninsured Americans, as the law intends, the cost of insuring chronic users of the system must be offset by the presence in the system of 2.7 million people between the ages of 18 and 35.
The primary question for young people is how much getting health insurance is going to cost them.
Reports are all over the map on this - some say less than before, others say way more. But it really depends on the young person's demographic profile: where he or she lives, the size and annual income of the household and other specifics, including which plan on the exchange they choose.
That sort of detailed breakdown isn't ready yet in New York or nationally. The White House won't release enrollment data through the federal health insurance marketplace until November.
New York's health department spokesperson Jeffrey Hammond said enrollment breakdowns by age in New York are being gathered but are not yet available.
The state exchange opened Oct. 1 and had signed up more than 134,000 people as of Friday morning.
One option available only to people under 30 is a so-called catastrophic policy that kicks in after a $6,350 annual deductible. In Monroe County, N.Y., you can buy that policy on the New York State of Health exchange for as low as $131 a month for single coverage.
As many young people are doing this sort of thing for the first time, research from reputable sources may help sort out the options. There are pitfalls, after all, as is true in any marketplace.
"We're taking it very seriously," Cassandra Moffitt said, as she explores the issue. She and her husband, David, operate Coworking Rochester. Many of the freelancers and others who rent space at the Coworking site are under 30.
The Moffitts not only have to buy plans for themselves but they also are inheriting a Montana business and have to figure out how to find and buy and pay for health plans offered in two states with separate health-care exchanges.
Despite the complications, Cassandra Moffitt said, she and David have little interest in avoiding the problem and paying the penalty. "We and our friends know how costly health care is," she said. "It's been clear for a long time."
The first of January next year will be a wake-up call for all young Americans.
But there are other wake-ups, and they can be just as unsettling.
Stephanie Plummer of Gates, N.Y., at 23, has a few more years to go on her parents' health plan before she's on her own and required to have health insurance. She carries a large college-loan debt and wasn't sure about the necessity of insurance until she encountered Lauren Taylor of Webster, N.Y.
Taylor, at 31, has breast cancer.
Plummer coaches a girls soccer team and they decided to help raise money for her.
It was then that Plummer realized two things. One, serious illness can strike a young person. Second, its treatment is crushingly expensive.
"Being close to her age, I saw what can happen," said Plummer.
"I felt the sticker shock. All of a sudden, I had the awareness."
Tom Tobin, Rochester (N.Y.) Democrat and Chronicle