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The technological trials for the online health insurance exchanges have turned an enrollment period that was supposed to be a leisurely three-month stroll into a last-minute sprint for millions of Americans. People who want coverage that starts at the beginning of 2014 need to sign up no later than Dec. 23.

Even for those with the will and drive to pursue treatment, the process remains difficult, frightening and full of holes. Mental health advocates say little has come, on the federal level, from the task forces and promises that followed the Newtown shootings.

People with employer-based health plans won't have to shop for coverage on the exchanges. Still, the federal health law can affect them. As employers adjust plans to meet new requirements, people can expect to see changes in their coverage.

Some Californians are choosing plans that don't comply with the Affordable Care Act to save money. They have only a few weeks left to pick coverage that will last a year. It will eventually be replaced by health insurance that includes a full range of essential benefits, but at a higher cost.

After Angelina Jolie announced she has a genetic variant that raises her risk of breast cancer, many women asked their doctors for the test. Insurers will pay for tests only if there's a clear indication that it would help shape medical care. That's often not the case.

Medicare has tied incentive payments and penalties to two-dozen quality measurements, including surveys of patient satisfaction and death rates. More than 1,200 hospitals are receiving bonuses. But more hospitals are being paid less for each Medicare patient they treat for the year that began Oct. 1.

With a few exceptions, all the policies sold on New York's health insurance marketplace won't pay for routine expenses from doctors or hospitals not in their networks.

Health plans that require people to pay thousands of dollars up front cut costs in the first three years, a study finds. But no one knows if costs will rise later as people avoid preventive care.

Millions of Americans might not be able to afford insurance if the Supreme Court rules the government erred in making subsidies available in all states. Arguments are

The federal government now factors patient satisfaction ratings into the rates Medicare pays hospitals. Some hospitals with lower ratings are finding it's difficult to change patients' perceptions.