Is it hard? Do I have to add a lot of extra stuff?

In nearly every case, no. The amount of work needed is minimal compared to the effort it usually takes to make a page inaccessible.
Once you know what you're doing, it's usually quite easy to make a page that can be used by everyone.

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	Designing for Universal Accessibility A FedWeb '98 Tutorial Presented by Kynn Bartlett, President, HTML Writers Guild