Good morning. Today's word count is 712 words, or <3 minutes.
Illustration: Sarah Grillo/Axios
As gene-altering technologies become more accessible, there's also a growing risk that they'll be dangerously misused or abused.
Why it matters: "You're talking about manipulating DNA to create a designer pathogen. That’s a terrorist threat," former FDA commissioner Scott Gottlieb told me.
The big picture: Ethical questions about CRISPR, the gene editing tool, are as old as the technology itself, and they intensified last year with the news of the first gene-edited babies in China.
Driving the news: NPR reported last week that as synthetic DNA gets cheaper and easier to make, there's growing concern about the technology being used to create bioweapons or dangerous viruses.
Meanwhile, scientific advances in genetics have made breakthrough therapies possible.
Gene testing — as opposed to gene altering — poses new risks, as well.
Drug companies facing expansive litigation over their role in the opioid crisis are exploring settling the cases by participating in Purdue Pharma's bankruptcy, the Wall Street Journal reports.
Why it matters: If successful, this would either end or shrink the massive federal case pending in Ohio. But it would require a lot of buy-in, including from state attorneys general.
Details: The companies — Endo, Johnson & Johnson, Teva, Allergan and Mallinckrodt — want to contribute money to a trust while being released from all liability.
Illustration: Aïda Amer/Axios
Sheriffs across Alabama are relying on what's known as "medical bond" to avoid paying for inmates' hospital bills, ProPublica reports — meaning that jails release the inmates from custody when they need medical care.
The big picture: ProPublica and AL.com reviewed media reports of sheriffs using these medical bonds in 25 states.
Between the lines: Medical care is expensive, and county budgets are often strained. But regardless of any ethical or legal concerns this approach raises, it doesn't just make these health care costs go away — it inevitably forces someone else to foot the bill.
Wellness programs that reward people for exercising or stopping smoking are common in employer plans, and soon they will be an option in individual health plan marketplaces, the Trump administration said in a bulletin yesterday.
The big picture: 10 states will get to experiment with wellness programs in their Affordable Care Act markets, and they generally have to comply with federal rules for employer wellness programs, Axios' Bob Herman reports.
The bottom line: We've said this before, but we'll say it again. All reputable evidence has concluded wellness programs don't lower costs, don't improve people's health, and raise legal and privacy concerns.
Patients are getting blindsided by "facility fees" in their hospital bills, a controversial charge that some medical facilities defend as necessary for additional income, Axios' Marisa Fernandez reports.
Driving the news: In Detroit, a facility fee was responsible for more than half of an insured patient's bill after she had a benign cyst removed from her abdomen, Kaiser Health News reports.
The state of play: The Health Care Cost Institute found that facility fee charges nearly doubled from 2009 to 2016, outpacing overall health spending four times over, NPR reports.
The bottom line: Ultimately, bills come out higher than patients budget for. Critics have called these fees a tax on sick people and argue that there's no formula for pricing.