Senate Democrats released a white paper yesterday detailing their goals for overhauling private health insurance and asking for feedback to help them translate those goals into policy.

Why it matters: The effort signals a radical revamp of how insurance is structured and regulated, with a particularly strong emphasis on lowering patients' costs across the board.

• It shows in broad strokes how the party is grappling with what can be done about private insurance, not just how to create more government-run coverage.
• It's designed for when Democrats next have total control of power in Washington, which would be 2029 at the earliest.

Driving the news: The group of Senate Democrats — led by Finance Committee Ranking Member Ron Wyden — released an 86-page request for feedback from stakeholders and policy experts on dozens of policy goals aimed at making private insurance more affordable and user-friendly.

• It makes clear that at least some members of the party want to open a new chapter in Democrats' health care policy agenda — one that's responsive to the system as it is today, including recent changes made under the Trump administration.

Between the lines: Democrats have been consumed for years with the question of how far to expand government-run insurance, with the party deeply divided over Medicare for All, an idea that could lead to the total abandonment of private insurance.

• The Senate Democrats' latest effort seeks a middle ground. It includes a section on the expansion of public insurance and a "Medicare-type choice," but devotes more real estate to the question of how to make private insurance work better.

Details: For example, it asks whether and how to limit patient out-of-pocket spending, including through deductibles and coinsurance.

• It asks for feedback and recommendations on "affordable caps on total spending, inclusive of premiums, deductibles and cost-sharing" and "a uniform approach to capping cost-sharing based on affordability."
• It also discusses expanding federal power to review premium increases.

Our thought bubble: Its inclusion of employer insurance is particularly noteworthy. Workplace insurance covers a much larger portion of the country than Affordable Care Act marketplaces, but has been left alone in recent major health care efforts.

Yes, but: Almost no one thinks health care's affordability issues can be solved solely through insurance reforms.

• Though Wyden and other Democrats are eager to further target prescription drug prices, there's no similar effort to address hospital and provider spending.

What they're saying: "We welcome the opportunity to work with regulators and policymakers to set the record straight around these market dynamics, avoid unintended consequences, and ultimately improve consumer experience and affordability," CVS said in a statement.

What we're watching: A Finance Committee aide told reporters that the hope is to start fleshing out specific policies next year.

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We didn't really learn anything about the origins of COVID from the Anthony Fauci hearing yesterday, but we did get to watch him take the Fifth Amendment over and over again.

• And we did learn that Fauci is probably going to be held in contempt. The Senate Homeland Security Committee is scheduled to take that vote next Wednesday, per a committee aide.

Why it matters: The hearing — and the contempt vote next week — are allowing Sen. Rand Paul to jump-start the questions about where COVID came from, and the theories that it was a lab leak from research about viruses, not the wet market in Wuhan.

• The hearing was also another showcase for Fauci's diary, which got plenty of write-ups after Paul released it — a move Fauci said was "aimed at embarrassing and intimidating me."

Driving the news: Fauci said Paul was trying to get him to say something that could put him in legal jeopardy. Paul said his use of the Fifth Amendment was "unsupported" since former President Biden preemptively pardoned Fauci before leaving office.

• Fauci argues he could be in trouble if he makes any statements that could open new lines of investigation for the committee.

What he's saying: Paul has an "unhinged obsession with me," and his motive for the hearing is to "get me to say something — anything — that could vindicate his repeated public pledges that I end up, in his words, quote, behind bars, unquote," Fauci said.

The other side: "There will be repercussions to your refusal to testify today," Paul warned Fauci.

• "The committee has issued a valid subpoena. ... The questions are very pertinent to your decision-making," Paul said.

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Planned Parenthood is asking a court to throw out Trump administration changes that would reorient a federal grant program away from preventing unintended pregnancy.

Why it matters: It's the latest challenge to Trump health officials' use of federal funding to advance conservative political goals.

Driving the news: Planned Parenthood Federation of America alleges in its lawsuit that officials' changes to so-called Title X family planning grant requirements violate administrative procedure laws and the Constitution's spending clause.

• Earlier this year, officials announced changes to the application requirements for the 2027–32 funding cycle that direct grantee clinics to promote "natural family planning programs," offer counseling that affirms marriage and parenthood, and meet other HHS priorities.
• The lawsuit, filed in the U.S. District Court for the District of Columbia, says the new requirements aren't in line with the intent of the program — and are also too vague.
• The ACLU filed a separate lawsuit seeking to invalidate the Title X changes last month.

What they're saying: "The unlawful, ideologically-driven changes to Title X threaten devastating consequences for lower income Americans nationwide who rely on the program for essential health care, including birth control, cancer screenings, and STI testing," Skye Perryman, CEO of Democracy Forward, said in a statement.

• The left-leaning legal nonprofit is helping represent Planned Parenthood in the lawsuit.
• HHS did not immediately respond to a request for comment.

💊 The FDA has launched a pilot program to monitor clinical trial data in real time, a change it says could help speed up drug approvals. (Reuters)

⛔️ The Trump administration has quietly shut down funding for many of the Agency for Healthcare Research and Quality's activities. (KFF Health News)

🚨 The FTC sued Hims & Hers, alleging that the telehealth company shared users' sensitive health information with advertisers — leading to a 10% drop in the company's shares. (CNBC)