President Trump as soon as this week is due to outline a new initiative that calls for a short-term extension of Affordable Care Act subsidies in exchange for new eligibility limits and other changes.

Why it matters: Mounting concern about medical costs and the looming expiration of enhanced ACA tax credits could amp up affordability concerns and give Democrats a potent weapon heading into an election year.

• Democrats made ACA financial assistance a centerpiece of the recent government shutdown fight.

What we're hearing: Trump plans to propose a framework that would address spiking premiums by extending for two years the enhanced ACA tax credits, which are due to expire at the end of the year, according to sources familiar, speaking anonymously because of the sensitivity of the talks.

• It would put an income limit on who's eligible for the tax credits and require recipients to make a minimum premium payment, eliminating $0 premium plans that Republicans say fuel fraud.
• The plan also would encourage people to buy lower-premium options on the ACA exchange.
• For individuals who downgrade their coverage, the difference in costs would be distributed to an health savings account provided with taxpayer dollars.

Still unresolved in the larger battle over the subsidies is whether there would be new prohibitions on using any financial assistance for elective abortions.

• Adding Hyde Amendment language to any deal would be highly controversial, with Democrats insisting there's already a mechanism to segregate taxpayer funds so they're not used to pay for the procedure.
• Treasury Secretary Scott Bessent appeared on NBC's Meet the Press on Sunday and teased that an announcement on health care costs would come this week.

Context: Trump recently has been adamant about not signing a straightforward extension of ACA subsidies, saying the money should be sent directly to consumers to shop for health services.

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A Washington state resident died from a strain of bird flu not previously seen in humans, marking only the second reported death from the virus in the United States.

Why it matters: Migratory birds are driving up avian flu cases across the country, reviving concerns about spillover to other species and possible human-to-human transmissions.

Driving the news: The individual who died on Friday was an older person with underlying health conditions who kept a backyard flock of poultry, the Washington State Department of Health said.

• The H5N5 strain of flu detected has previously been reported in animals but never before in humans. Health officials said they haven't identified any increased risk to the public.
• The event underscores how viruses constantly reassort, or swap gene segments, when they infect the same cell, which results in cross-species jumps.

Between the lines: The UDSA says there have been 76 confirmed outbreaks in flocks over the past 30 days, affecting 1.6 million birds in 19 states.

• Infections have also been found in livestock and other mammals in recent months.
• H5N5 isn't more dangerous than the more prevalent H5N1 flu strain that started spreading to dairy herds last year and has infected several dozen people.

A federal judge on Friday blocked the Justice Department from obtaining personal information and medical records of patients who received gender-affirming care at Children's Hospital of Philadelphia.

Why it matters: Caught in a showdown between federal power and patient privacy laws, the hospital sought to limit the scope of a sweeping federal subpoena for data surrounding transition-related care provided to people under 19.

• The requested information included names, addresses and Social Security numbers of patients prescribed puberty blockers and hormone therapy, their families' identifying information, and medical treatment records including diagnoses.

Driving the news: District Court Judge Mark Kearney, an Obama appointee, wrote that DOJ didn't show it had the authority to compel the information under the Food, Drug, and Cosmetic Act and that the patients and their families' privacy interests "far outweigh" the department's need for the information.

Context: The Philadelphia hospital's Gender and Sexuality Development Program is among the largest in the country providing care for transgender and nonbinary children.

• Its case was part of a broader effort by the Trump administration to subpoena hospitals for data surrounding transition-related care for people under 19 provided since the beginning of 2020.
• The actions are tied to executive orders on gender that President Trump issued during his first weeks in office. But critics say the campaign is testing the boundaries of executive powers and could undercut federal and state protections.

People who could conceive naturally are choosing in vitro fertilization to screen embryos for genetic traits linked to cancer risk, IQ, height and more, causing unease among doctors and bioethicists.

Why it matters: Doctors warn that the science behind embryo scoring for complex conditions is shaky — and could push would-be parents toward major decisions based on unproven data.

• Elective IVF also is reopening old debates about "designer babies," and the ethics of hand-picking certain traits for future children.

Driving the news: Preimplantation genetic testing for embryos used in IVF has gained in popularity.

• Companies are even offering a variety that uses DNA databases from adults to estimate an embryo's genetic predisposition to conditions that aren't driven by just a single gene.
• These polygenic tests can cost several thousand dollars on top of IVF, which can total tens of thousands more.

It's an "emerging consumer phenomenon" for people who don't have fertility issues or known genetic risks to do "elective IVF for the purposes of having a healthier, taller [child], whatever 'best' is to them," said Kian Sadeghi, CEO of genetic testing startup Nucleus Genomics.

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💸 Eli Lilly reached a market valuation of $1 trillion in trading Friday, becoming the 10th member of an elite U.S. club dominated by the tech behemoths. (Axios)

👀 The White House asked for the resignation of a top aide to FDA commissioner Marty Makary who Makary had sought to promote, in the latest sign of tensions between Makary and HHS leadership and the White House. (Politico)

⚕️ The granddaughter of former President John F. Kennedy revealed her terminal cancer diagnosis and rebuked her cousin, Health Secretary Robert F. Kennedy Jr., for medical research cuts. (New Yorker)