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Bernie Sanders celebrated the health care concessions he won from Hillary Clinton Monday night as he gave a rousing endorsement to his former presidential rival. In a Democratic convention speech that revisited the agenda of his surprisingly competitive campaign for the nomination, Sanders reminded the audience that while he may have lost the race, he did succeed in convincing Clinton to support three important proposals: a “public option” for Obamacare, letting people join Medicare early, and a big funding increase for community health centers. (Kaplan, 7/26)

[T]he Trump vs. Clinton race offers voters a stark choice, starting with their views on the Affordable Care Act, also known as Obamacare. Clinton wants to improve it and make it more affordable. Trump has vowed to kill it, starting on the day he takes office. Abortion? Clinton is decisively pro-choice; Trump, pro-life, a stance bolstered by his selection of Indiana Gov. Mike Pence, a champion of abortion restrictions, as his running mate. ... We have pulled together an at-a-glance list summarizing their views on a range of health and science issues. It shows not only their differing opinions, but also their differing styles. Clinton is given to detailed policy positions; Trump, not so much. (Giordano, 7/24)

The success of the conservative approach to Medicaid devised by Indiana Gov. Mike Pence—Donald Trump's pick for vice president—is a mixed bag so far, according to a report that offers fodder for both sides of the political spectrum. A new analysis funded by the state shows both positive and concerning elements to Indiana's alternative Medicaid expansion. It again exposes the dichotomy of Pence embracing President Barack Obama's healthcare reform law even though his presidential running mate, Donald Trump, has called for full repeal of the Affordable Care Act. (Dickson, 7/25)

The 2016 Democratic Party platform includes strong pro-abortion rights language. It opposes Republican efforts to defund Planned Parenthood, as well as bids to overturn the Hyde Amendment, which limits federal funding for abortions. In contrast, the Republican platform called for repealing Roe vs. Wade and adding a "personhood" amendment to the Constitution, which protects a fetus from the beginning of its development. Here & Now's Robin Young talks to Edel Finnegan, executive director of the Pro-Life Union of Greater Philadelphia, about how abortion is being talked about by the parties and the candidates this year. (Young, 7/25)

State-based marketplaces survived startup problems with botched technology and political threats but continue to grapple with a fundamental challenge: financial sustainability. The 13 states that run their own exchanges face challenges in raising enough money, through user fees or state funding, to maintain their operations now that about $5 billion in early federal grants has largely run out. As states establish those budgets, they are testing decidedly disparate approaches to investments in priorities like marketing, technology and operations. (Mershon, 7/25)

Insurance premiums for Affordable Care Act individual policies may not be as expensive as presumed when compared to rates before the law took effect, a recent analysis suggests. The analysis, released last week by Health Affairs, argues that though premiums are increasing, they’re actually lower than they would have been before the Affordable Care Act was implemented in 2010. That’s because the “average premiums in the individual market actually dropped significantly upon implementation of the ACA,” the analysis says. (McIntire, 7/25)

One of Kansas’ largest health insurers is trying to reduce costs and improve the quality of care for at least some of its customers in the Topeka area. Blue Cross and Blue Shield of Kansas announced Monday that it had formed an accountable care organization, or ACO, with SCL Health, the parent company of St. Francis Health, which operates a hospital and more than 20 physician clinics in the region. (Hart, 7/25)

Software startup Zenefits must pay the state of Tennessee $62,500 for violating insurance requirements, state officials said on Monday, marking the first settlement with regulators as the scandal-hit company seeks to redeem itself after revelations it had flouted the law. "Under the company's past leadership, compliance with insurance laws and regulations was almost an afterthought," Julie Mix McPeak, commissioner of the Tennessee Department of Commerce and Insurance, said in a statement. "Under the old Zenefits model, they were not complying with state laws. Fortunately, new company leadership has demonstrated a dedication to righting the ship." (Somerville, 7/25)

Zenefits faces several continuing investigations from other states, including Washington, California and Massachusetts, after the company failed to get the necessary licenses for its sales staff to broker health-insurance benefits, the primary way the startup makes money. Zenefits reported its licensing issues to all 50 states earlier this year and said it has stopped the unlicensed practices. The company won’t be restricted from doing business in Tennessee, said Zenefits’s chief executive, David Sacks, in an email to employees that was released by the company. (Winkler, 7/25)

Zenefits reached its first settlement with a state government over its use of unlicensed health insurance brokers, an issue that prompted investigations in at least three other states and led its founding chief executive officer to resign this year. As part of the settlement, Zenefits said it will pay the Tennessee Department of Commerce and Insurance $62,500 in fines. The company will continue to sell insurance in the state. (Huet, 7/25)

Tennessee is the first state to impose a fine against one-time Silicon Valley darling Zenefits for not complying with state laws around selling insurance. The $62,500 civil penalty from the Tennessee Department of Commerce and Insurance wraps up a months-long evaluation that started when Zenefits self-reported to states across the country in November that it breached laws including allowing unlicensed brokers to sell health insurance. (Fletcher, 7/25)

U.S. health officials are strongly urging doctors to ask all pregnant women about a possible Zika infection at every checkup. So far, there have been no confirmed cases of a Zika infection from a mosquito bite in the United States, although officials expect mosquitoes will start spreading it in Southern states. All U.S. illnesses have been connected to travel to areas with Zika outbreaks. (7/25)

The new guidance, issued Monday, also applies to pregnant women who have no symptoms. The agency is updating its guidance because of new research showing the virus can stay in the blood of pregnant women for longer than the previously recommended seven-day window for testing after symptoms begin. Even pregnant women without symptoms can have evidence of the virus in their blood and urine, the CDC said. (Sun, 7/25)

By urging testing for more pregnant women, the recommendations “will improve our ability to give definitive diagnoses of the Zika infection to those women who are at the highest risk,” said Margaret Honein, who chairs the CDC’s birth defects branch. She was also a co-author on the guidance. (Luthra, 7/25)

The Centers for Disease Control and Prevention (CDC) on Monday updated its guidance in order to address the possibility of the Zika virus spreading from women to men through sex. The update comes after the first female-to-male sexual transmission of the disease was reported in New York City earlier this month. (Sullivan, 7/25)

Federal health officials have decided not to proceed with plans to begin aerial spraying on Puerto Rico in order to prevent the spread of the Zika virus. The move came two days after the city of San Juan last week filed a lawsuit to prevent federal health officials from pursuing spraying. The step came amid heated debate over the extent to which spraying an insecticide called Naled will have a negative effect on human health and wildlife. In its lawsuit, which was filed on July 21 in federal court in San Juan, the city argued the spraying will “pose a significant risk to the well-being of several species of fish, wildlife, and plants.” The suit also cited “a serious risk to the general health” of San Juan residents. (Silverman, 7/25)

Local transmission of the Zika virus will happen in Florida this summer, federal health officials predicted during a visit to Orange County Mosquito Control on Monday...What's concerning officials most is the devastating effects of the virus on unborn babies. So far, 12 babies have been born in the U.S. with Zika-related birth defects, such as microcephaly. (Miller, 7/25)

Health officials here on Monday declared an end to the Zika epidemic in Colombia, the first time a South American country had turned the tide on the disease, they said. ... While health officials said the number of new infections had decreased to 600 new cases a week, they added that they still expected a limited number of new cases in the coming months as the disease wound down. (Casey, 7/25)

More than a dozen athletes have dropped out of the 2016 Olympic games in Rio de Janeiro citing fears of spreading the Zika virus, but a new study from researchers at Yale University finds that the international sporting event poses little risk of increasing the transfer of the virus around the world. “Yes, Zika is a serious disease, but transmission linked to the Olympics and ParaOlympic Games is not a substantial public health threat and policy should be guided by this fact,” said Gregg Gonsalves, co-director of the Yale Global Health Justice Partnership and an author on the paper. (Netburn, 7/25)

While there have not yet been any locally contracted cases of the virus, health officials are taking steps to protect against Aedes aegytpi, the mosquito species endemic to South Florida and primary transmitter of Zika virus. As of Monday, Florida had 358 travel-related Zika cases, including 48 cases involving pregnant women regardless of symptoms, second in the country after New York. (Cochrane, 7/25)

For professional athletes and weekend warriors alike, it appeared to be welcome news: the discovery by researchers of a new knee ligament that, if repaired, might help tens of thousands of people with an injury from sports or an accident. In the fall of 2013, a study about the finding was published in a small medical journal, generating extensive press coverage in the United States and Europe. A Florida company quickly began marketing a repair procedure those researchers helped develop. And soon, patients were asking about the knee surgery, and doctors were performing it. (Meier, 7/25)

As the nation’s opioid addiction epidemic expands, older adults in Maine and other states face mounting barriers to getting help for abuse of alcohol and opioid painkillers — not the least of which is finding they are squeezed out of scarce treatment facilities by younger people with prescription drug or heroin habits. (Vestal, 7/26)

Gov. Larry Hogan is announcing a $540,000 state grant to test an alternative to incarceration for those convicted of nonviolent crimes linked to heroin or opioid addiction. It’s called a day reporting center, and it’s planned for a vacant office building near the Washington County Sheriff’s Office near Hagerstown. Hogan said in a statement Monday that the center will combine drug-addiction treatment with supervised probation. Offenders who are sent there will have to be employed or actively seeking employment. (7/25)

As opioid addiction rises, public health advocates in Maryland are calling for more treatment where many addicts end up: in jails and prisons. In Maryland, only Baltimore and a few counties offer any treatment in their jails. The state-run jail in Baltimore offers only detoxification. The state offers some counseling in its prisons and continues detox for 21 days. But advocates and treatment professionals say it's not enough to keep addicts off the drugs over the long term. (Cohn, 7/25)

More than half of adults and 44 percent of children who were drug-tested by a national clinical laboratory last year misused their prescription medications, according to a study released Monday by Quest Diagnostics. Misuse of medications can mean that patients were either taking too much, too little or none of their medications. It also can mean test results showed they were using other drugs that had not been prescribed, including illicit drugs -- as 45 percent of adults were doing, the study found. (Kindy, 7/25)

If the Internet is a public forum, then social media is the megaphone installed at the center of it. Certainly it attracts oversharers, the ones who hash out breakups in Facebook statuses and live-tweet their days in embarrassing detail. We lurk in the cyber shadows and tsk and snicker — this is modern voyeurism at its most entertaining. But then there are people like my acquaintance who seem to be in a different, more dangerous kind of distress that seems private but is broadcast, intentionally or not, to a wide network of onlookers. It looks suspiciously like mental illness. (Tepper Paley, 7/25)

“My paternal grandfather had breast cancer.” That always makes whoever is charting my medical history look up. “He had a radical mastectomy in the 1970s. And his sister had it, too — she died young. And one of his nieces. And his daughter — my aunt.” At age 37, I have just been diagnosed with breast cancer, and the genetic counselor is furiously sketching out my family tree on a sheet of paper. There are squares and circles, the cancer victims marked with X’s. Lots of X’s. (Riggs, 7/25)

In the world of advocacy for children with disabilities, life-threatening conditions and chronic disease, a new generation of advocates is emerging: the patients themselves. ... Advocacy has often been dominated by parents of children with the disorders. One of their greatest successes is that, through better daily care, funding, and advocacy, even in cases of lethal illness, the children generally are living longer, better lives. Some of those children now are at an age where they are forcing advocacy groups and their own parents to take their views into account, even when opinions diverge. (Dockser Marcus, 7/25)

A new study out of Rice University finds that when patients make observations about their own health, they’re usually right. The study, published this week in the journal Psychoneuroendocrinology, gathered the results of a health questionnaire and then blood samples from 1,500 participants. They tested the blood samples for inflammation and the latent herpes virus, neither of which usually produce obvious symptoms. (Caiola, 7/25)

The study — led by a doctor at the University of Colorado Anschutz Medical Campus — found that emergency room visits and poison-control calls for kids 9 and younger who consumed pot in Colorado jumped after recreational marijuana stores opened. About twice as many kids visited the Children’s Hospital Colorado emergency room per year in 2014 and 2015 as did in years prior to the opening of recreational marijuana stores, according to the study. Annual poison-control cases increased five-fold, the study found. (Ingold, 7/25)

To a child on the prowl for sweets, that brownie, cookie or bear-shaped candy left on the kitchen counter is just asking to be gobbled up. But in states that have legalized marijuana for recreational use, notably Colorado, that child may end up with more than a sugar high. A study published on Monday in the journal JAMA Pediatrics says that in Colorado the rates of marijuana exposure in young children, many of them toddlers, have increased 150 percent since 2014, when recreational marijuana products, like sweets, went on the market legally. (Hoffman, 7/25)

As a new mental health court gears up to start hearing cases next month, Montgomery County is poised to become the latest Texas locality to join a national trend of sending nonviolent offenders with serious mental illnesses to treatment rather than prison. (Kragie, 7/25)

Rocky Mountain Health Plans, a dominant and long-independent provider of health insurance coverage in western Colorado, has struck a deal to join UnitedHealthcare, the largest health insurer in the state and the country...UnitedHealthcare said it will invest an undisclosed amount in RMHP to “restore the organization’s capital base and help ensure that it becomes a stronger, more sustainable health plan over the long term.” (Svaldi, 7/26)

Texas unveiled Monday a revamped women’s health program for low-income residents that includes a boost in family planning services that the conservative state will no longer let Planned Parenthood and other organizations affiliated with abortion providers offer. More than 5,000 health care providers are part of the new program, Healthy Texas Women, said Charles Smith, head of the Texas Health and Human Services Commission. That’s a 30 percent increase from 2014, and about triple the number of providers in the state women’s health program as recently as 2011. (Weissert, 7/25)

Children’s Hospitals and Clinics of Minnesota is opening an intensive care simulation in its Minneapolis hospital to train medical students and staff. The new room, which comes complete with child- and baby-size mannequins and beeping equipment, is meant to accurately reproduce the high-stress environment of an intensive care unit and will allow teams to practice procedures during simulations of medical emergencies. (Beckstrom, 7/25)

Residents of four neighborhoods near the Lowry Avenue Bridge in Minneapolis are raising concerns about air pollution after a study they commissioned found elevated death rates, including from cancers and asthma, in the area. Researchers hired by the neighborhood didn’t pinpoint a cause of the deaths, but activists didn’t hesitate Monday to point fingers at the GAF roofing factory next to the bridge. (Brandt, 7/25)

How many times have you had a conversation about when are “they” going to find a cure for the common cold, or make decent-tasting vegan cheese? Well, what if you had a chance to do it yourself? That’s the idea behind the trend of do-it-yourself biohacking: to get regular people involved in scientific discovery. A group of DIY scientists at a new crowdfunded lab in Oakland are doing just that. (Stelzer, 7/25)

The Georgia secretary of state says he is postponing his removal of the state nursing board’s executive director until August of next year. Secretary of State Brian Kemp’s decision in June to remove Jim Cleghorn, and replace him with the head of the state’s cosmetology board, has proved controversial. Many nurses across the state have said they were angered and puzzled by the planned ouster of Cleghorn. In a letter last week to Georgia nurses, Kemp said that because his office’s nursing education consultant position is vacant, “it is not the best time to make this change.’’ (Miller, 7/25)

Earlier this spring, Gov. Mark Dayton set up a task force that will propose legislation to improve the state's mental health systems. Tom Weber talks with Emily Johnson Piper, Commissioner of the Minnesota Department of Human Services, who is leading that task force. (Weber, 7/26)

A North Texas company whose president gave state Attorney General Ken Paxton $100,000 last year to fight his felony fraud indictments will pay $3.5 million after allegations it skimped on services to Medicaid and Medicare patients while over-billing the government. A former employee who brought the original lawsuit against Preferred Imaging LLC, a medical diagnostic company headed by James H. Webb of Frisco, alleged the company was performing services that require the oversight of a supervising doctor without one on-site. (McGaughy, 7/25)

The abortion plank in the 2016 Democratic platform effectively marginalizes the voices of 21 million pro-life Democrats. It means the party that is supposedly on the side of justice for the vulnerable no longer welcomes those of us who #ChooseBoth; that is, those of us who want the government to protect and support prenatal children and their mothers. (Kristen Day and Charles Camosy, 7/25)

It's hard to avoid the conclusion that the party's pro-choice components have consolidated power. There is little in the polls to support a more liberal posture on the issue. Since Gallup began tracking abortion in the 1970s, the main default position of Americans has been support for abortion "only under certain circumstances." (Francis Wilkinson, 7/25)

When a congressional panel investigating the procurement of fetal tissue from abortion clinics was formed last fall, its Republican leader and members made no secret of their mission to expose businesses that “sell baby body parts.” (They even said as much on their website.) Their inquiry was inspired by hidden-camera videos (later discredited) that supposedly showed Planned Parenthood officials negotiating over payments for harvested fetal tissue. It’s illegal in the U.S. to profit from the sale of fetal tissue — payments are limited to the cost of collecting and handling it — so if the committee actually found organizations doing that, it would be legitimate to bust them. (7/25)

The Affordable Care Act continues to provide an opportunity for religious zealots to complain that someone, somewhere, might be doing something of which they disapprove. Another such case advancing through the courts is that of Missouri State Rep. Paul Wieland and his wife, Teresa, who assert that Obamacare’s contraceptive mandate tramples on their family’s religious rights even if they don’t make use of it. St. Louis Federal Judge Jean Constance Hamilton thinks they may have a point. On Thursday she denied the government’s motion to throw out the case on summary judgment. Merely requiring individuals to buy an insurance policy that provides contraception could infringe on their religious conscience, she ruled in clearing the case for trial. (Michael Hiltzik, 7/25)

The federal government's own actuaries are once again pessimistic that America's health-care costs will continue their slow growth. Thankfully, their boss, Sylvia Burwell, the secretary of Health and Human Services, is working hard to prove them wrong. On Monday, she took another big step in the right direction. Medicare costs this year are up only 4 percent, which means that on an inflation-adjusted basis, spending per beneficiary is declining. (Peter R. Orszag, 7/25)

National action in response to superbugs is growing. In 2015, the White House released the National Action Plan for Combating Antimicrobial-Resistant Bacteria. While we applaud this effort, these domestic steps need to be accompanied by a much stronger global approach. The reality is drug resistance usually emerges in parts of the world where antibiotic use in people and animals is rampant, poorly regulated and largely untracked. (Lisa Cohen, Guy Palmer and John Lynch, 7/24)

The big rate increases announced last week for health insurance policies sold by California’s version of the federal health reform are the latest evidence that the Affordable Care Act, despite its name, cannot do much to tame the rise of health care costs. The government-run health insurance market is facing all the same cost pressures that the private market has confronted for years, plus more that have resulted from the dynamics of the federal law itself. Covered California, the state insurance agency created to implement the federal law, announced last week that rates for insurance sold through the program will increase an average of 13.2 percent in 2017. (Daniel Weintraub, 7/25)

In the wake of the brutal killings of Alton Sterling, Philando Castille, Delrawn Small, and police officers in Dallas and Baton Rouge, America is confronting how its long history of racial injustice continues into the present. We must all address these wounds, including those of us in medicine. As medical students soon to be entrusted with the health and well-being of individual patients and entire communities, we see responding to these tragedies as intertwined with our professional responsibilities. (Jocelyn Streid, Margaret Hayden, Rahul Nayak and Cameron Nutt, 7/25)

State-supported mental health care is now available only for the sickest of the sickest of the sick. As a rough rule of thumb in any medical or mental health care delivery system, 20 percent of the people consume 80 percent of the money. The state chose an all-or-nothing response to limit the types of services and the number of people covered. ... North Carolina is now in the process of repeating this same mistake in its unnecessary and politically driven effort to reform Medicaid, which delivers medical care to the poor, the great majority of whom are children. Unlike the mental health care system, the Medicaid system in North Carolina run by Community Care of NC has been a model of care delivery that has received national recognition. (David Horowitz, 7/24)

Addiction Recovery Care (ARC) is a drug and alcohol treatment organization with centers in Eastern and Central Kentucky and is headquartered in Louisa, Kentucky. Addiction is devastating our region. Our region has suffered from one of the worst prescription drug abuse problems in the nation. Now, we see overdoses increasing as heroin and fentanyl flood into the mountains. (Tim Robinson, 7/25)

The plight of the elderly, mentally ill and disabled who are unable to take care of themselves is heartbreaking, but until recently their fate was luck of the draw: Many had loving families who stepped in as legal guardians; others got good-hearted community volunteers; some got diligent attorneys who worked under very minimal court supervision; and others — hundreds of Franklin County’s 7,000 wards — got crooked lawyers who had turned guardianship appointments into a cottage industry and stole their wards’ money, dignity and freedom. (7/26)

The 26th anniversary of the Americans with Disabilities Act is certainly something to celebrate. But it also highlights how much work still needs to be done. A recent article in the Washington Post pointed out a paradox that the parents of children with special needs are all too familiar with: while the federal government has for decades required states to accommodate the special needs of people with disabilities like cerebral palsy and autism, Congress has never provided the money to do so. (Brian Roy, 7/26)