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. The state’s two biggest insurers, Blue Shield and Anthem Inc., will increase rates by 19.9 percent and 17.2 percent, respectively.

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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.

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Progressive supporters of health reform wanted a public plan option to compete with private insurers offering insurance in the state and federal health exchanges. To draw support from progressives, proponents of the Patient Protection and Affordable Care Act (ACA) created a type of nonprofit health insurance cooperative that would compete with established health insurers. Consumer Operated and Oriented Plans, or health insurance COOPs, as they are commonly known, were a political compromise for those who supported allowing non-seniors to buy their way into Medicare or a similar public program.

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In a presidential campaign that has been much more about personality than policy, here’s some news: A lot of Americans really do care about health care.

Terrorism and the personal attributes of Donald Trump and Hillary Clinton top a list of 10 issues that registered voters consider “extremely important” in a recent poll, but not far behind are gun policy, the economy and, at No. 5, health care. The Kaiser Tracking Poll found 37 percent of voters checked off this issue.

And the 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.

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Pence has always been a vocal opponent of the Affordable Care Act, even after the federal law passed in 2010 and was upheld by the Supreme Court.

But when faced with the choice of whether to expand Medicaid to cover Indiana residents who earn incomes that are 138 percent or below the federal poverty level — a key part of the ACA — Pence made a compromise. He debuted a conservative-friendly version of the expansion, one that requires Medicaid recipients to pay a monthly contribution, based on income, into a health savings account.

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The Obama administration went to court Thursday to block two major health insurance mergers, siding with consumer advocates and medical groups worried that the consolidation of large national health plans could lead to higher premiums.

The long-anticipated move by the Justice Department and attorneys general in California and 10 other states,  will at least temporarily prevent Anthem Inc.’s $48-billion purchase of Cigna Corp., a combination that would create the nation’s largest health insurer.

And it will stop Aetna Inc.’s $34-billion bid to acquire Humana Inc., a merger that would have combined the nation’s third- and fifth-biggest health plans.

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The Journal of the American Medical Assn. recently published a very unusual article: a scientific study authored by a sitting president of the United States. That’s never happened before.

In a sense, it’s cool that President Obama cares enough about science to want to publish a paper in one of the world’s leading medical journals. But JAMA has set a bad precedent. The article, on healthcare reform in the United States, is problematic not only in its content but in the threat it poses to the integrity of scientific publishing.

It would be difficult, if not impossible, to find another paper in any scientific journal in which a politician was allowed to subjectively analyze his own policy and declare it a success. This is a textbook definition of conflict of interest.

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Politicians tend to be most enraged by the problems they cause, and the liberal fury against insurance mergers is a classic of the genre. ObamaCare was designed to create government-directed oligopolies, but now its authors claim to be alarmed by less competition.

Last week federal and 11 state antitrust regulators filed a double lawsuit to block the pending $54 billion insurance tie-up between Anthem and Cigna and the $37 billion acquisition of Humana by Aetna.

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The man selected by presumptive Democratic presidential nominee Hillary Clinton as her vice presidential running mate is a strong ally of Clinton’s in her push for improving the Affordable Care Act and expanding Medicaid to more states.

Virginia Sen. Tim Kaine, whom Clinton named Friday as her running mate, has sponsored several bills to fix gaps and glitches in the ACA and to encourage more states to extend Medicaid to low-income adults. None have won Republican support and passed. He also has strongly backed Virginia Gov. Terry McAuliffe’s unsuccessful efforts up to now to expand Medicaid in his own state.

As governor in 2009, Kaine signed a letter with 21 other governors to congressional leaders urging them to enact federal healthcare reform legislation.

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Hillary Clinton led a health care reform effort in the 1990s, promoted medical research as a senator, and has been bashing price-hiking drug companies on the campaign trail and in TV ads.

So there’s every reason to expect her to make health care a major theme when she accepts the Democratic presidential nomination in Philadelphia on Thursday night. What she says about the future of medical research, public health, and the uninsured will give a valuable preview of what her priorities would be — and how far she’s willing to go to co-opt the ideas of her defeated rival, Bernie Sanders.

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