Leading hospital associations appear to be on a collision course with health insurance providers over payment of insurance premiums.

One of the major concerns insurers have is whether the millions of individuals who buy insurance when the Patient Protection and Affordable Care Act kicks in will be able to send in a premium check promptly every month.

Many of those who will buy coverage through state exchanges and other avenues haven't had coverage in the past because they couldn't afford it. Now, the PPACA will essentially require these folks to buy insurance or pay a fine. But will they consistently be able to pay?

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