It actually only holds at 25 degrees C and it's b/c 1x10^-14 is the Kw at that temp. It will be slightly different at different temperatures.
Ka x Kb = Kw
As for the value of Kw, it comes from the equilibrium expression for auto-ionization in water.
Kc = [H+][OH-]/[H2O]
Divide both sides by the concentration of water so you have:
Kc x [H2O] = [H+][OH-]
Kc x [H2O] = Kw
So really Kw is just the equil constant for water at a given temperature x the concentration of pure water which is 55M at 25 C.
I'm sure that's way more info than you need on the MCAT but that's the reasoning behind it.