In an analysis by a team of reporters and data researchers, the New York Times reported on Oct. 26 that the Affordable Care Act has largely succeeded in delivering on President Barack Obama's main promises.

At its most basic level, ACA was intended to reduce the number of Americans without health insurance. Measured against that goal, it has made considerable progress. The number of Americans without health insurance has been reduced by about 25 percent this year - or 8 million to 11 million people, and over the next four years, the law is projected to expand coverage to millions of Americans.

When signed the measure in 2010, he pledged that it would protect Americans from ruinously high medical bills by guaranteeing them access to comprehensive - and affordable - coverage. For millions of people who gained insurance through the law, this has proved true. Dire warnings that the law would cause premiums for most people to rise sharply have proved unfounded. The law has spurred competition, with new companies entering the market. Early indications are that premium increases for 2015 will be relatively modest.

Perhaps the loftiest and hardest to demonstrate was the ACA would make the nation healthier. Experts say it is too soon to tell whether the ability of more people to get mammograms, colonoscopies or just routine checkups will, as Obama and other supporters promised, eventually prevent chronic diseases in many more people. But some early data suggest that in one population, young people, the law is having a positive impact.

Will the exchanges work better this time around? Federal and state officials, and a number of outside experts, say they think it will."I'm a realist, and we will not get it perfect," said Andrew Slavitt, principal deputy administrator at the Centers for Medicare and Medicaid Services, at a congressional hearing in September. "But we have, I think, the right processes in place to make it as good as it should be."

From the beginning, opponents of ACA have warned that it represented a "government takeover" of the health care system that would lead to crippling regulations on for-profit companies and nonprofit players. But Wall Street analysts and health care experts say the industry appears to be largely flourishing, in part because of the additional business the law created. "The irony is if you look sector by sector, ACA has resulted in pretty substantial earnings across the board," said Paul H. Keckley, managing director of the Navigant Center for Healthcare Research and Policy Analysis, a consulting firm unit. One clear sign that the carriers find the market attractive is the decision by more of them to offer policies through the online health exchanges.

Architects of ACA saw the expansion of Medicaid, the government health-care program for low-income people, as a crucial step toward Obama's goal of reducing the number of uninsured. In states that have expanded eligibility - to include people with incomes up to 138 percent of the poverty level (up to $16,105 for an individual) - Medicaid appears to be achieving that goal."States that expanded Medicaid have seen a remarkable reduction in the number of uninsured, a drop of nearly 40 percent," said Stan Dorn, a health policy expert at the Urban Institute, a nonprofit research group. "That compares with a reduction of less than 10 percent in states that have not expanded."

Chip Tuthill lives in Mancos. Website used:www.nyt.com