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Insurance enrollment will be a key yardstick for assessing whether the Affordable Care Act is working. Almost as important as the total number of people who get coverage is whether a significant percentage of them are healthy.

Many health insurance policies for part-time workers will end next year and won't be renewed. Better quality choices will likely be on the menu for these workers, though they are also going to cost people more.

The medical screening tests offered by churches and other nonprofits may sound like a great idea. But some of the tests, which are performed by for-profit companies, are not recommended by national organizations because they can lead to invasive testing and unnecessary treatment.

For the system to work, however, age won't be as important as how healthy or unhealthy all the new enrollees are. And insurers won't really know that until next year, when claims start rolling in. Sick people are more motivated to sign up early, researchers say.

No one knows for sure right now how many of the estimated 14 million people who buy their own coverage are getting cancellation notices, but the numbers appear to be big. Some insurers report discontinuing 20 percent of their individual business, while other insurers have notified up to 80 percent of policyholders that they will have to change plans.

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.

The Affordable Care Act included a sales tax on medical devices that is supposed to help pay for the expansion of health insurance coverage. But the tax is being levied on some devices, such as ultrasound scanners, that are used to diagnose and treat animals instead of humans.

Plans offering coverage that lasts 364 days can cost half as much as those that are in force for a year. But the savings may be illusory for people who need care for injuries or illnesses because the coverage can be skimpier.

The president offered a fix for people whose insurance coverage has been canceled because it didn't meet the minimum standards of the federal health law. But will insurers follow through? And even if they want to, will state regulators let them?

Maryland-based Evergreen Health Co-op is one of nearly two dozen nonprofit insurers created by the health act. They will be owned by the policyholders and are supposed to add competition and lower prices for coverage. they're supposed to add competition and lower prices for medical coverage. But they can't do either without customers.