Julie Appleby, Kaiser Health News

Low-income consumers struggling to pay their premiums may soon be able to get help from their local hospital, but the hospitals' efforts have set up a conflict with insurers.

When a car rolls off an assembly line, the automaker knows exactly what parts, labor and facilities cost. Not so in healthcare, and now some health executives are trying to change that.

To keep premiums down on the new insurance marketplaces, payers have created smaller networks of hospitals. But just how small are they?

When it comes to providing consumers with easily accessible information about physician quality, a report out Dec. 10 gave most states grades of 'D' or 'F,' often because they compile data only about primary care doctors, not specialists.

Despite laws in 17 states allowing them to practice independently, nurses with advanced degrees say some insurers still don't accept them into their credentialed networks as primary care providers.

Even as many states gear up for tougher insurance regulations under the federal health law, Maine lawmakers last year bucked the trend, loosening rules they blamed for some of the highest premiums in the nation.

President Obama's recent pronouncement in favor of same-sex marriage has no legal effect on employers' decisions on whether to offer benefits to workers' domestic partners, but some advocates believe it could reinforce a decade-long trend toward coverage.