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January 2, 2014

Four ways to tell if Affordable Care Act is working

WASHINGTON — We are now days into the health-care law's insurance expansion, which began at midnight on Jan. 1. And it is, alas, far too early to tell if the nation's new health-care reform is working. We know that no "death panels" have materialized but, aside from that, have very little information about how the Affordable Care Act's newly insured are changing our health-care system.

It is not too early though to think a bit about what "working" actually means. There are a handful of ways that we tend to measure the success of health insurance expansions in the United States. The Patient Protection and Affordable Care Act (ACA) is no exception here; it's a complex law where there are at least four policy outcomes that all count as some definition of "working."

Do more people have health insurance?

One key goal of the health law was to reduce the uninsured rate by making it easier for the 48 million Americans without insurance coverage to get it. The Congressional Budget Office projects that about 30 million people will gain coverage over the next decade, compared to a scenario where the ACA had never passed. That will be one yardstick by which to tell if the health-care law is working: Whether more people have coverage.

This is actually difficult to measure, at least in the short-term, because there's no national clearinghouse of people who do or don't have insurance. The combination of insurance cancellations and exchange sign-ups make it really hard to know, at this very moment, whether the health law has led to a net gain in coverage. The Census Bureau does do annual surveys on insured rates, but those come out on a bit of a delay. The federal agency won't publish data on 2014, for example, until the fall of 2015.

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Obituaries
  • Alan J. Walker, 68

    Kingston, N.H. — Mr. Alan James Walker, 68, passed away peacefully at his home on July 8, 2014, after a long, brave battle with cancer.

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  • James Reese

    Raymond, NH — James Edwin Reese, 74, passed away on Wednesday, July 16, 2014, surrounded by his family and friends at his home in Raymond, N.H. He was the son of John and Ruth Reese, born on Oct. 29, 1939 in Edensburg, Pa. James graduated from Central Cambria High School in Pennsylvania before proudly serving in the U.S. Army as a food inspector. His military service was followed by 31 years with the U.S. Department of Agriculture as a meat inspector. Mr. Reese was an avid outdoorsman and spent much of his time fishing, camping and hiking in the White Mountains. He became involved in the Boy Scouts and enjoyed passing on his vast knowledge of the wilderness to others. Throughout his retirement years he enjoyed woodworking, raising rabbits and working in his garden.

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  • Velma J. Reid

    South Hampton, NH — Velma J. Reid, 80, died peacefully on July 17, 2014 at Exeter Hospital, surrounded by family. She was born in Haverhill, Mass. on June 8, 1934, the daughter of the late George C.W. and Alta I. (Kimball) Haynes. A graduate of Haverhill High School, Velma worked at Western Electric until she had children. For years, she was a devoted “stay-at-home” mom who raised her three children in a loving, nurturing environment. She later worked various manufacturing jobs until her retirement. After retiring, she volunteered her time at various organizations and was very involved at the East Kingston Community United Methodist Church as a member of the women’s guild, assisting with the holiday fair, and helping out wherever she could. She had a passion for animals, and would donate money, food, and blankets to the NH SPCA. She loved to sew and made a personalized quilt for every member of her family. She was also a member of the “Ugly Quilts” group, which made blankets and sleeping bags for the homeless using recycled fabric. She is survived by her husband, Clyde Reid of South Hampton, N.H.; daughter, Pam Eaton of Danville, N.H.; son and daughter-in-law, Douglas and Kim Reid of Raymond, N.H.; daughter, Shirley Reid of South Hampton, N.H.; two sisters, Gwen Stuart of Haverhill, and Norma Taplin of Dracut; four grandchildren, Cheryl and Marc Welch, and Kristen and Joshua Reid, and several nieces and nephews.

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  • Carleen A. Knowlton, 80

    Danville, NH — Carleen A. (Rhoadhouse) Knowlton, 80, of Danville and formerly of Hampstead, died on July 7, 2014, at her home.

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  • Miriam O. (Graham) Graham, 84

    Kingston, NH — Miriam O. (Graham) Graham, 84, a resident of Kingston since 2001, and former longtime resident of Grafton, Mass., died peacefully, surrounded by her family, on July 11, 2014, following a long illness.

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