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Florida Seeks Drug Prescription Data With Names of Patients and Doctors

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Florida Seeks Drug Prescription Data With Names of Patients and Doctors

Florida’s insurance regulator has demanded an unusually intrusive trove of data on millions of prescription drugs filled in the state last year, including the names of patients taking the medications, their dates of birth and doctors they’ve seen.

The Florida Office of Insurance Regulation in January sought this information from pharmacy benefit managers like UnitedHealth’s Optum Rx and CVS Health’s Caremark, companies that oversee prescription drugs for employers and government programs.

It remained unclear why the state was ordering the submission of so much data. In a letter to one benefit manager reviewed by The New York Times, the regulator said the state required the data to review whether the benefit managers, known as P.B.M.s, were compliant with a 2023 state law aimed at lowering drug prices and reining in the managers.

But the demand is sparking concerns about government overreach and patient privacy.

“You don’t need such granular patient information for purposes of oversight,” said Sharona Hoffman, a health law and privacy expert at Case Western Reserve University. She added: “You have to worry: Is the government actually trying to get information about reproductive care or transgender care or mental health care?”

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Florida’s six-week abortion ban, enacted by Gov. Ron DeSantis, a Republican, and the state’s Republican-dominated legislature, requires that doctors who prescribe abortion pills dispense them in person, not through the mail. Another Florida law banned transgender transition care for minors and made it harder for adults to seek such care. Last year, a judge struck down key parts of that law, though it is still being enforced while the legal fight makes its way through the courts.

The data requested by the state could, in theory, be used to determine whether physicians are complying with those laws.

It was also unclear whether any of the benefit managers had complied and turned over the information to the state.

Some benefit managers and the employers that hire them to handle prescription drug benefits for their workers have also criticized the state’s demand.

A group of large employers, the American Benefits Council, is asking the Florida regulator to withdraw its order to turn over the information. In a letter to the state, the council’s lawyers wrote that the “demand impermissibly violates the health privacy and security of millions of Floridians,” and that the state had not clearly outlined its authority or reasons for the action.

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“We have a duty to employees and their data,” Katy Johnson, the president of the council, said in an interview.

Shiloh Elliott, a spokeswoman for Florida’s insurance regulator, said that objections to the state’s data request “are clearly from those who do not want to be regulated or have any oversight in their industry.” She said the office “will continue to request data in the best interest to protect consumers.”

Rosa Novo, the administrative benefits director for Miami-Dade County Public Schools, which provides health coverage to about 45,000 people, said in an interview that while she appreciated the state’s efforts to address drug prices, it was unclear why it would need this level of detailed information about patients and their medications.

“My doctor is the only one who should know that,” Ms. Novo said.

Federal privacy law allows benefit managers to hand over limited data about individual patients in certain circumstances, such as when regulators are conducting an audit. But, according to experts, Florida’s data request could violate the law because it is so broad and may go beyond what the regulator needs to conduct its review.

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Experts said that another concern with Florida’s request is that when sensitive patient data is in multiple hands, it raises the risk of a breach in which the information may be stolen.

Ms. Elliott, the spokeswoman for the regulator, said those concerns “should be addressed to the actual health care insurance companies that have had countless data breaches exposing millions of Americans’ sensitive information.”

Florida’s data order was first reported by Bloomberg.

Like other states, Florida already has access to some of the data it is seeking, such as detailed information about prescriptions that are paid through Medicaid. But that data is generally strictly walled off, accessible only to staff members whose jobs require it.

Benefit managers often field requests from government regulators asking for slices of data to conduct audits or investigations. Such requests typically ask benefit managers to strip out patient names, and other identifying details, or ask for a small sample of patient claims.

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By comparison, Florida’s data request was “pretty expansive and unprecedented,” said Joseph Shields, the president of a group of smaller benefit managers, Transparency-Rx.

Florida sought data not only on Florida residents, but also on patients who may have filled a prescription while visiting the state. Its request included patients covered through the federal Medicare program and commercial plans through employers that are regulated under federal law rather than state law, according to the regulator’s letter to one benefit manager reviewed by The Times.

The Prescription Drug Reform Act, the Florida law the regulator used to justify the data request, imposed new reporting requirements on the benefit managers but said nothing about a mandate requiring them to turn over such detailed patient information. Benefit managers have fiercely fought efforts to scrutinize their business practices.

Patricia Mazzei contributed reporting from Florida.

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See How Home Insurance Premiums Are Changing Near You

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See How Home Insurance Premiums Are Changing Near You

Insurance premiums are rising fast in the parts of the United States most exposed to climate-related disasters like wildfires and hurricanes.

New research shows that, as insurance has sharply pushed up the cost of owning a home, the price shock is starting to reverberate through the broader real estate market.

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Rising insurance costs are eating into household budgets.

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Note: “High end” refers to the top decile of homeowner payments in each county. The 2023 values are shown for Vermont because of discrepancies in the source data.

The New York Times

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In some areas of the country that are exposed to disasters, homes are not selling because prospective buyers can’t afford both the mortgage and the insurance.

In parts of the hail-prone Midwestern states, insurance now eats up more than one-fifth of the average homeowner’s total housing payments, including mortgage costs and property taxes. In Orleans Parish, La., that number is nearly 30 percent.

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Home insurance costs have soared where climate hazards are highest.

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Source: Keys and Mulder (National Bureau of Economic Research, 2025)

Note: The 2023 values are shown for Vermont because of discrepancies in the source data.

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The New York Times

Nationally, insurance rates have risen by an average of 58 percent since 2018, outpacing inflation by a substantial margin. But that growth has been highly uneven across the United States.

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Source: Keys and Mulder (National Bureau of Economic Research, 2025)

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Note: “High end” refers to the top decile of homeowner payments in each county. The 2023 values are shown for Vermont because of discrepancies in the source data.

The New York Times

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Places that are most vulnerable to climate-related disasters like hurricanes, fires and hail are seeing some of the largest premium increases. It’s not always the case that the highest climate risk translates into the highest insurance costs. Local policies and regulations have helped keep prices lower in high-risk places, like parts of California. Other factors, like a homeowner’s credit score, can affect premiums, too.

What’s driving up insurance prices?

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Since 2017, an obscure part of the insurance market, known as reinsurance, has helped push up premiums. Insurance companies buy reinsurance to help limit their exposure when a catastrophe hits. Over the past several years, reinsurance companies have experienced what Benjamin Keys and Philip Mulder, the researchers who led the new study, call a “climate epiphany.” As a result, the rates they charge to protect home insurance companies against catastrophic losses have roughly doubled.

Insurance providers have, in turn, passed these costs on to homeowners. The rapid repricing of climate risk is responsible for about 20 percent of home insurance premium increases since 2017, according to Dr. Keys and Dr. Mulder.

What else is contributing to high rates? Rebuilding costs are responsible for about 35 percent of the recent changes, the research found. Population shifts and inflation are factors, too.

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High insurance prices are weighing down home values.

Since 2018, a financial shock in the home insurance market has meant that homes in the ZIP codes most exposed to hurricanes and wildfires sell for an average of $43,900 less than they otherwise would have, the research found.

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Source: Zillow

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Note: Chart shows percent change in Zillow Home Value Index since 2018.

The New York Times

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In many places, insurance has been a relatively small part of the homebuying equation. Now, for many, it’s a major consideration.

For several homeowners we interviewed in Louisiana, monthly insurance costs are now higher than their home loan payments.

The research shows buyers may be factoring rising insurance costs into the prices they’re willing to pay for homes. As a result, homes in some areas are selling for less.

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Methodology

Benjamin Keys and Philip Mulder calculated annual homeowners’ insurance costs by separating mortgage and tax payments from loan-level escrow data obtained from CoreLogic, a property and risk analytics firm. Households whose payments were captured by CoreLogic were not necessarily present in all years of data from 2014 to 2024.

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The home insurance share of total home payments is based on mean values. Total home payments include insurance, property tax and mortgage principal and interest costs. Escrow payments typically do not include utilities, homeowners’ association fees.

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L.A. County’s first flu death confirmed in a season that could be harsh

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L.A. County’s first flu death confirmed in a season that could be harsh

L.A. County has had its first flu death in a season that health officials have warned could be severe.

The county Department of Public Health confirmed the influenza-associated fatality on Wednesday.

The death occurred in an elderly individual with underlying health conditions who had not received a flu vaccination this season, according to the Department of Public Health.

“We send our condolences to the family and loved ones of the person we lost. This tragic death reminds us how serious influenza can be,” Dr. Muntu Davis, Los Angeles County health officer, said in a news release.

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Flu activity is low at the moment, though it is likely to increase with Thanksgiving next week and the holiday season, which typically involves more plane travel and indoor gatherings.

Last year’s flu season was the worst California had seen in years — and state health officials have already warned that this year could be just as bad.

Health experts, including the Centers for Disease Control and Prevention, recommend an annual flu vaccination for everyone older than 6 months.

Nationwide, the number of children who died from flu last season — 280 — was the highest in about 15 years, according to one report. About 9 in 10 of those children were not vaccinated, officials said.

The flu vaccine can be administered at the same time as the COVID-19 vaccine and takes two weeks for protection to develop.

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“You can also reduce your risk by taking simple but powerful steps,” Davis said. “[W]ash your hands frequently, stay home and away from others when you feel sick, and wear a well-fitting mask in crowded indoor spaces, around people at higher risk, or whenever you have symptoms.”

As respiratory virus activity increases in L.A. County, the Department of Public Health also recommends that everyone 6 months and older receive an updated COVID-19 vaccine. RSV immunization is also recommended for older adults, pregnant people and infants.

L.A. County residents can find a vaccine site near them by visiting the department’s website.

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Rising Home Insurance Premiums Are Eating Into Home Values in Disaster-Prone Areas

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Rising Home Insurance Premiums Are Eating Into Home Values in Disaster-Prone Areas

This Louisiana resident expects to pay 45 percent more for home insurance this year.

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Similar increases are hitting homeowners across the state, where insurance costs have exploded over the past four years.

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It’s part of a rapid shift that’s sending tremors through real estate markets across the country.

Even after she escaped rising floodwaters by wading away from her home in chest-deep water during Hurricane Rita in 2005, Sandra Rojas, now 69, stayed put. A fifth-generation resident of Lafitte, La., a small coastal community, she raised her home with stilts.

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But this year, her annual home insurance premium increased to $8,312, more than doubling over the past four years.

She considered selling, but found herself in a dilemma. As insurance costs have risen, area home values have fallen, dropping by 38 percent since 2020. The roadsides around her house are dotted with for-sale signs.

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“They won’t insure you,” Ms. Rojas said. “No one will buy from you. You’re kind of stuck where you are.”

Sandra Rojas is a fifth-generation resident of Lafitte, La.

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New research shared with The New York Times estimates the extent to which rising home insurance premiums, driven higher by climate change, are cascading into the broader real estate market and eating into home values in the most disaster-prone areas.

The study, which analyzed tens of millions of housing payments through 2024 to understand where insurance costs have risen most, offers first-of-its-kind insight into the way rising insurance rates are affecting home values.

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Since 2018, a financial shock in the home insurance market has meant that homes in the ZIP codes most exposed to hurricanes and wildfires would sell for an average of $43,900 less than they would otherwise, the research found. They include coastal towns in Louisiana and low-lying areas in Florida.

Changes in an under-the-radar part of the insurance market, known as reinsurance, have helped to drive this trend. Insurance companies purchase reinsurance to help limit their exposure when a catastrophe hits. Over the past several years, global reinsurance companies have had what the researchers call a “climate epiphany” and have roughly doubled the rates they charge home insurance providers.

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Source: Keys and Mulder (National Bureau of Economic Research, 2025). The New York Times

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Benjamin Keys at the Wharton School of the University of Pennsylvania and Philip Mulder of the University of Wisconsin-Madison, the authors of the study, which was published this week, have called these swift changes “a reinsurance shock.” For some Americans, these changes have made it unaffordable to remain in homes they have lived in for decades.

“Homeowners don’t appreciate or don’t understand that we are living in a much riskier world than we were 25 years ago,” Dr. Keys said. “And that risk? They have to pay for it.”

After analyzing 74 million home payments — which included mortgage, taxes and insurance and were made between 2014 and 2024 — the researchers found that a rapid repricing of disaster risk had been responsible for about a fifth of overall home insurance increases since 2017. Another third could be explained by rising construction costs.

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The researchers estimated the effects of the reinsurance shock on home prices in the ZIP codes most vulnerable to catastrophes. They found that rising insurance premiums weighed down home values by about $20,500 in the top 25 percent of homes most exposed to catastrophic hurricanes and wildfires, and by $43,900 in the top 10 percent.

Buying a home has long been seen as a way to lock in predictable housing costs. But the fast-increasing burden of insurance is catching some homeowners by surprise.

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Last year, Ms. Rojas’s brother-in-law, who lived down the road in Lafitte, decided to sell his home to escape the area’s rising premiums. It sold for $150,000, which is what it cost him to build it in 1984. He estimated he lost about $75,000 on the sale, after accounting for the cost of renovations.

In parts of the hail-prone Midwestern states, insurance now eats up more than a fifth of the average homeowner’s total housing payments, which include mortgage costs and property taxes. In Orleans Parish, La., that number is nearly 30 percent.

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Source: Keys and Mulder (National Bureau of Economic Research, 2025). The New York Times

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A hundred miles north of Lafitte, the small city of Bogalusa, La., lies further inland. Nevertheless, Cristal Holmes saw her insurance premium more than quadruple in 2022, to $500 per month, on top of her $700 monthly mortgage.

Ms. Holmes, a single mother who was working 56 hours a week at a warehouse, struggled to keep up with the higher bills. She fell behind on mortgage payments after her work hours were reduced to 35 per week. She worried she couldn’t stay in her home.

Similar stories are playing out all over town. Ms. Holmes’s real estate agent, Charlotte Johnson, said her office was getting phone calls every day from people who said they could no longer afford their rising insurance premiums. For many, dropping insurance is not an option, because banks refuse to offer or maintain mortgages for people without coverage.

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That means owners are being forced to choose between accepting home insurance policies they can’t afford or risking foreclosure.

Buyers face their own obstacles. High insurance prices and interest rates are making it harder than ever for first-time buyers to purchase homes, said Nancy Galofaro-Cruse, a senior loan officer with CMG Home Loans who works with many of Ms. Johnson’s clients. She estimated that more than a third of would-be buyers in the area backed out of the market this year after insurance and interest rates pushed their total monthly housing costs out of reach.

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For-sale signs dot roadsides In Lafitte, La., where high insurance costs have driven residents to sell.

It’s not just the hurricane-prone coasts that have been affected by the reinsurance shock. In Colorado, where wildfires and hail pose the biggest threats to homes, the average homeowner’s premium has more than doubled in the last decade and median premiums have increased 74 percent since 2020.

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Steve Hakes, an insurance broker with Rocky Mountain Insurance Center in Lafayette, Colo., has seen clients consider homes in wildfire-prone areas, only to back out when they can’t find affordable insurance. High prices and limited availability have pushed him to advise buyers to look for insurance early in the homebuying process.

And in California, 13 percent of real estate agents surveyed by an industry trade association said they’d had deals fall through in 2024 after buyers couldn’t find affordable insurance coverage.

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Colorado regulators are aware of the threats these dynamics pose to the real estate market and are exploring a wide range of fixes, said Michael Conway, the Colorado insurance commissioner.

“We don’t want a situation where the insurance market is effectively decimating the real estate market,” he said.

As insurance becomes more expensive, home values will need to adjust for potential buyers to afford their monthly costs, industry analysts say. And if home values fall, lower property tax revenue could mean less money for local governments to pay for essential services or affect the ability of those governments to borrow money.

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Clarence Guidry reached a breaking point this year when he got a quote to insure his home in Lafitte, La. He’d pay a $20,000 annual premium but if a hurricane struck, he’d be on the hook for the first $50,000 in damage before the insurance company would pay out.

His lender wouldn’t let Mr. Guidry, who goes by Rosco, keep his mortgage without home insurance. But keeping his home insured against damage from hurricanes would mean stomaching monthly payments that are at least 40 percent higher than the rest of his monthly mortgage and property taxes combined.

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Clarence Guidry, a homeowner in Lafitte, La., would need to cover the first $50,000 in hurricane damage before his home insurance would kick in.

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Over the last decade, as the number of wildfires and storms has mounted, losses have exceeded the revenue insurance companies receive from home insurance policies across the United States. In Louisiana, 12 companies, including Mr. Guidry’s insurer, became insolvent after a wave of hurricanes between 2021 and 2023. (Most private insurers do not cover flood damage, which is handled separately under a federal program.)

Note: Data shows U.S. property catastrophe prices indexed to 1990. Source: Guy Carpenter. The New York Times

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Insurance companies’ own costs have climbed in recent years for a variety of reasons, including higher construction costs, higher interest rates and President Trump’s tariff policies.

But the changes in the insurance market have begun to put a higher price on risk. Reinsurers have been driving these effects, Dr. Mulder said.

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“These reinsurers are looking at a lot of the same data as insurers, but at a much bigger scale and with more sophistication,” he said.

Politicians, homeowners, economists, state insurance commissioners and real estate agents have long worried that insurance costs will rise so much that they will begin to pull down home values.

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According to the study by Dr. Keys and Dr. Mulder, which was published as a working paper in the National Bureau of Economic Research, this is already happening in some areas.

Jesse Keenan, an associate professor of sustainable real estate and urban planning at Tulane University, said the direct evidence of this phenomenon remained limited and there were factors beyond insurance that affected local home prices.

But there are increasingly troubling signs in some markets, he said.

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“The New Orleans housing market is exhibiting signs of failure that are imposing stress on the financial system around it,” he said.

Overall, U.S. home prices have risen about 55 percent since 2018, but New Orleans prices have increased by only 14 percent, less than the rate of inflation over the same time period.

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Note: Chart shows change in Zillow Home Value Index since 2018. Source: Zillow. The New York Times

Even in states where heavy regulations have kept costs down, there are signs that home insurers will continue to raise premiums to align more closely with disaster risk. New rules in California allow insurance companies to pass rising reinsurance costs on to consumers. One consumer advocacy group, citing the effects of similar changes in other states, has estimated this provision could raise net premiums significantly for homeowners.

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Back in Lafitte, Mr. Guidry was running the numbers for his own budget. Against the advice of his financial adviser, he took money out of his retirement account to pay off his home loan. The plan now is to self-insure for wind and hail damage. That means he and his wife will have to pay out of pocket to repair their home if another severe storm hits.

In forgoing coverage, the Guidrys join some 13 percent of U.S. homeowners who are uninsured, according to Census Bureau data. Insurers continue to drop people in many areas.

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“Now, we’ve got to take the gamble,” Mr. Guidry said.

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Methodology

Benjamin Keys and Philip Mulder calculated annual homeowners’ insurance costs by separating mortgage and tax payments from loan-level escrow data obtained from CoreLogic, a property and risk analytics firm. Households whose payments were captured by CoreLogic were not necessarily present in all years of data from 2014 to 2024.

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The home insurance share of total home payments are based on mean values. Total home payments include insurance, property tax and mortgage principal and interest costs. Escrow payments typically do not include utilities, homeowners’ association fees.

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