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Killer whales are killer whales, right? It might be a lot more complicated than that

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Killer whales are killer whales, right? It might be a lot more complicated than that

More than 150 years ago, a San Francisco whaler noticed something about killer whales that scientists may be about to formally recognize — at least in name.

Charles Melville Scammon submitted a manuscript to the Smithsonian in 1869 describing two species of killer whales inhabiting West Coast waters.

Now a new paper published in Royal Society Open Science uses genetic, behavioral, morphological and acoustic data to argue that the orcas in the North Pacific known as residents and transients are different enough to be distinct species. They propose using the same scientific names Scammon is believed to have coined in the 19th century.

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Killer whales, found in all oceans, are currently considered one global species. The new proposed species would mark the first split of the ferocious apex predators, which, if approved, could have significant conservation and scientific implications — in addition to furthering a decades-long quest to properly classify the whales.

The two proposed species may look indistinguishable to the untrained eye, but there are subtle differences in their fins and markings — and many more unseen ones. They don’t speak the same “language” or nosh on the same food. And they have no interest in hanging out with one another, despite often dwelling in the same waters. Most significantly, researchers say, their DNA shows clear distinction.

Transients — also called Bigg’s killer whales — hunt seals and other marine mammals in small packs in expansive waters stretching from Southern California to the Arctic Circle. And they’re not very chatty while they sneak up on prey — they need to maintain stealth. They sport pointy, triangle-shaped dorsal fins with a solid white “saddle patch” behind it.

Residents, meanwhile, stick to fish — primarily Chinook salmon. They love to gab and hang out with the family. In fact, most offspring stay with their mothers their entire lives. Because fish don’t hear very well, they’re free to chatter as they chow down. Residents hew closer to coastlines, from Central California to southeast Alaska, where salmon congregate. Their fins tend to curve back toward the tail and intrusions of black sometimes extend into their saddle patches.

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A third type of killer whale roams the Pacific, but less is known about it; these offshore whales live farther out and prey on sharks and other large fish. A recent study found evidence of another, previously unknown group in the open ocean.

Taxonomy, the scientific discipline of naming and classifying animals, is how we break down critters into species. It’s an intellectual exercise that has real-world consequences.

“We’re facing a global conservation crisis, losing species that we don’t even know exist,” said Phillip Morin, the new study’s lead author and a marine mammal geneticist at the National Oceanic and Atmospheric Administration’s Southwest Fisheries Science Center.

If you think of killer whales as one species — a big pie — then killing some of them off here might not be a cause for concern, Morin said. But if you start parsing out species and subspecies — slices of the pie — then it’s suddenly possible to lose a unique, irreplaceable group.

A portion of the fish-eating resident killer whales — known as Southern Residents — is already listed as endangered in the U.S. and Canada. Salmon depletion from overfishing and habitat destruction has starved them, and only about 75 are left now. But if they’re designated as part of a species, the International Union for Conservation of Nature will assess them (and transients) separately.

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Study co-author Thomas Jefferson, a marine mammal biologist, also with NOAA’s Southwest Fisheries Science Center in La Jolla, believes the residents would probably be categorized on the conservation union’s Red List as threatened or endangered, possibly even critically endangered.

About 20 years ago, when Morin first began his foray into the world of marine mammal genetics, he said there was agreement that the taxonomy of cetaceans — which includes whales, dolphins and porpoises — was “really poor.”

Classification of land animals is often done by measuring bones, but water dwellers are hard to collect and store. Researchers don’t have extensive collections of whale skulls in museums from around the world, and it isn’t necessarily ethical to acquire them. They needed other tools — such as better genetics, drone recordings and satellite tagging — which didn’t exist yet.

“The genetics has now finally come to the point where we can do this on a broad scale and get the kind of resolution and information that we didn’t have,” Morin said.

Over two decades, researchers went from analyzing thousands to billions of base pairs of DNA from individual killer whales. The enhanced detail has allowed scientists to “look back through time,” Morin said, and answer questions about which killer whale populations are closely related — or not — and when differences emerged.

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Based on their genetic analyses, Morin and his team estimate that transients diverged from other orcas between 200,000 and 300,000 years ago, while residents began to split off about 100,000 years ago.

Only a small tissue sample is needed to analyze killer whale DNA to tell a big genetic story.

“We can actually go out with a crossbow and collect a little teeny bit of tissue from a living whale — just shoot a little dart at it and collect a little bit of skin,” Jefferson said.

Of course, scientists in the 19th century dedicated to describing and categorizing whales didn’t have access to this cutting-edge technology.

Virtually nothing was known about marine mammals of the West Coast of North America in the mid-1800s, when Charles Melville Scammon, the whaler, began meticulously documenting and measuring cetaceans, Jefferson said. (Scammon bears no relation to Herman Melville, author of whale-centric “Moby Dick.”)

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When Scammon’s paper from 1869 describing a variety of cetaceans of the West Coast, including orcas, made it to the Smithsonian, he had “every reason to believe that his article would be well received,” according to “Beyond the Lagoon,” a biography of the seaman. He knew things no other zoologist did because of his proximity to the whales and keen eye.

In a paper penned three years later, Scammon paints a vivid picture of killer whales, from their “beautifully smooth and glossy skin” to their “somewhat military aspect,” even including drawings. He recounts a gruesome attack, seen in “Lower California,” by a trio of killer whales on a gray whale and her baby.

The orcas assaulted the pair for at least an hour, eventually killing the younger whale while exhausting the mother. “As soon as their prize had settled to the bottom, the trio band descended, bringing up large pieces of flesh in their mouths, which they devoured after coming to the surface,” Scammon wrote. “While gorging themselves in this wise, the old whale made her escape, leaving a track of gory water behind.”

What Scammon didn’t know was that his earlier manuscript would fall into the hands of Edward Drinker Cope, a naturalist who had a reputation for being overly ambitious and warring with colleagues for credit.

Cope, secretary of the Academy of Natural Sciences of Philadelphia, slapped his own introduction on the paper with descriptions and Latin names of the orcas inhabiting the Northern Pacific.

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Because of rules governing the scientific naming of animals, Cope would forever be credited with the names believed to have been chosen by Scammon. Nevermind that Cope probably never saw a living killer whale.

The paper also misidentified Scammon and gave him little credit. When the whaler saw it, he was furious, according to the biography.

“It‘s a really, really strange and very weird and dramatic episode in the history of marine mammal biology, how these names came about,” Jefferson said.

Many of Scammon’s observations turned out to be erroneous. Often he logged differences between male and female killer whales rather than differences between species, said Michael Milstein, a spokesperson for NOAA. But his inquiry set the stage for more rigorous research to come.

Morin and his research team propose using the same Latin names from more than a century ago for the species they identified in their recent study.

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The researchers call transients Orcinus rectipinnus, noting that, in Latin, “recti means right or upright, and pinna means fin, feather, or wing, most likely referring to the tall erect dorsal fin of males.”

Residents, meanwhile, are labeled Orcinus ater. Ater means black or dark, according to the study, “which probably refers to the largely black color of this species.”

All killer whales are currently classified as Orcinus orca, a macabre nod to their vicious reputation. Some say Orcinus means “of the kingdom of the dead,” a reference to Orcus, a Roman god of the underworld.

There are also common, or informal names, to consider.

The researchers suggest sticking with “Bigg’s” for transients, honoring Michael Bigg, the father of modern-day orca research.

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The team plans to consult tribes who have a connection to the resident whales, including the Lummi Nation and Tulalip tribes of the Northwest, before settling on a common name, according to Milstein.

“They decided not to try to rush it to match the paper, but to take the time to make sure it is done in a way that everyone understands and believes in,” Milstein said.

John Durban, an associate professor with Oregon State University’s Marine Mammal Institute and co-author of the new study, said he supports using the name “Blackfish,” which is used by some tribes in the Pacific Northwest.

Complex rules govern the discipline of taxonomy, and typically a specimen must be designated as a reference point when it’s first named.

However, the original specimens studied by Scammon were destroyed or disappeared. According to Jefferson, one at the California Academy of Sciences in San Francisco was wiped out by the historic 1906 earthquake and subsequent fire. Another, believed to have been in Scammon’s personal possession, can’t be found.

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So the researchers found stand-ins at the Smithsonian.

Whether the broader community of marine mammal biologists will accept the researchers’ findings — and adopt Scammon’s and Cope’s names — will soon be determined.

The proposal is slated to go before a committee from the Society for Marine Mammalogy, which will vote in a few months on whether to greenlight designation of the species. Jefferson and another author of the new study sit on the committee and will recuse themselves from the vote.

Even today, Scammon has to contend with detractors.

Robert Pitman, a marine ecologist with Oregon State University who was not involved in the study, isn’t “entirely happy” with the names put forth.

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The names were conceived “before science, by and large, especially biological science, had any rigor,” Pitman said. “And then the descriptions that [Scammon] puts with those names are just so vague. I’m kind of doubtful that those names will stand.”

Names aside, he expects most marine mammalogists will be on board with the proposed species; many have suspected species-level differences among the well-studied whales of the Pacific Northwest. He said the case for splitting off the mammal-eating transients is particularly strong.

The newly identified species are believed to be harbingers of more to come.

Pitman, who has studied killer whales in Antarctica for over 10 years, said there’s a similar divide between mammal- and fish-eating killer whales in those waters.

There are five identified types, and Pitman thinks at least one will turn out to be a different species. Some look dramatically different.

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“And it’ll probably be easier now that somebody’s already made the first step in saying, ‘There’s more than one species out there.’”

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Senators Press Marty Makary on Abortion Pills and Vaccines

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Senators Press Marty Makary on Abortion Pills and Vaccines

At a confirmation hearing for Dr. Marty Makary on Thursday, senators focused heavily on the safety of the abortion pill, with Republican lawmakers urging him to restrict access and Democratic lawmakers demanding that he maintain its current availability.

Dr. Makary, President Trump’s nominee to lead the Food and Drug Administration, signaled that he shared Republicans’ concerns about the current policy, issued during the Biden administration, which expanded access by allowing people to obtain the pills without an in-person medical appointment.

Several Democrats pointed to volumes of studies showing that the drugs are safe. Dr. Makary told members of the Senate health committee, which held the hearing, that he would review the pill’s safety and the policy at issue.

He said he would “take a solid, hard look at the data and to meet with the professional career scientists who have reviewed the data at the F.D.A. and to build an expert coalition to review the ongoing data, which is required to be collected.”

The hearing also touched on vaccines, with several lawmakers, including the committee chairman, Senator Bill Cassidy, Republican of Louisiana, questioning why an advisory committee meeting on next year’s flu vaccine had been canceled in recent weeks and asking whether it would be held later. He and others stressed that the flu panel met annually, and some reminded Dr. Makary that Robert F. Kennedy Jr., who oversees the F.D.A. as health secretary, had pledged transparency in agency decision-making.

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Senator Patty Murray, Democrat of Washington, called the cancellation “unprecedented and dangerous” after decades of annual meetings.

Dr. Makary repeatedly reminded senators that he was not responsible for scrapping the meeting. He also suggested there was a need for a broader review of the role of vaccine committees that convene experts to advise the F.D.A. He shot back at criticism, saying there is a “huge difference” between “requiring every 12-year-old girl to get an eighth Covid booster” and “rubber stamping” the vaccine chosen by a global health panel that had targeted dominant influenza strains.

He offered no details about any school or entity that requires children to have annual Covid boosters.

He also was questioned about the measles vaccine in light of the current outbreak in Texas, where one child has died and 22 people were hospitalized.

“Vaccines save lives,” Dr. Makary said. “I do believe that any child who dies of a vaccine-preventable illness is a tragedy in the modern era.”

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But he did not take the bait lobbed by Senator John Hickenlooper, Democrat of Colorado, who criticized Mr. Kennedy’s endorsement of vitamin A and cod liver oil as remedies for measles. Dr. Makary responded by saying that supplements can improve conditions like malnutrition, which is associated with poor outcomes in measles outbreaks.

Lawmakers also warned about staff cuts and hiring freezes the Trump administration has ordered and how they could affect workers who inspect the safety of the food supply, and urged Dr. Makary to review the layoffs among those staff members whose salaries are backed by industry fees.

They also touched on work related to chemicals like dyes in the food supply, an area Dr. Makary agreed to study, invoking European products with fewer additives as an area for review.

Among other issues raised during the hearing, the vexing problem of illegal vape products from China with unknown ingredients was stressed by Senator Ashley Moody, Republican of Florida.

The vapes tend to have high levels of nicotine, advertise thousands of puffs and come in flavors like strawberry lemonade that are appealing to adolescents.

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Ms. Moody said it was concerning that the products were banned within China.

“Whoever comes in as the head of F.D.A., this is one of your problems you have to address immediately,” said Ms. Moody, who was previously Florida’s attorney general.

Blocking the flow of the unauthorized vapes has been a priority for major tobacco companies that have followed F.D.A. rules and marketed vapes in tobacco or menthol flavors in the United States. It’s a priority public health groups also share. Dr. Makary said he would address the problem with the F.D.A.’s law enforcement division and the Justice Department.

Throughout the hearing, several senators returned to the abortion pill and the F.D.A.’s oversight of policy changes during the lengthy history of medication abortion over more than two decades.

Mifepristone — part of the standard two-drug medication regimen now used in nearly two-thirds of abortions — has become a focal point of anti-abortion efforts since the Supreme Court overturned the national right to abortion in 2022.

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In a lawsuit filed against the F.D.A. and other efforts, abortion opponents have demanded that the agency either withdraw approval for mifepristone or roll back regulations to prevent abortion pills from being prescribed by telemedicine and mailed to patients.

The Biden administration waived the in-person dispensing requirement in 2021. Senator Maggie Hassan, Democrat of New Hampshire, said that she was concerned that Dr. Makary would “unilaterally overrule the data that currently exists for political purposes and for political reasons.”

Dr. Makary repeated that he had no preconceived notions and would examine the data. “I wish you were hedging a little bit less today,” Ms. Hassan shot back.

Mifepristone, which blocks progesterone, a hormone necessary for pregnancy to develop, has long been regulated by the F.D.A. under an especially strict program that applies to only a small number of drugs.

For years after its approval in 2000, mifepristone could be prescribed only by a doctor and patients were required to attend three in-person doctor visits to obtain and take the medication. In 2016 and 2021, based on updated scientific evidence, the agency made several changes, including that nurse practitioners and some other health care providers could prescribe mifepristone and that patients did not have to pick up the medication in person.

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Senator Josh Hawley, Republican of Missouri, argued that the policy change to drop the requirement for in-person appointments was made in anticipation of the Supreme Court decision that overturned Roe v. Wade.

Reproductive health experts and organizations, however, had long argued that the requirement was unnecessary for safety and noted that the F.D.A. had already allowed women to take the medication at home without being supervised by a doctor. The Covid pandemic increased the importance of allowing people to obtain the pill by mail because many patients were not able to visit clinics or abortion providers.

Pressed further by Mr. Hawley, Dr. Makary signaled that he shared the concerns of some abortion opponents and said that he knew doctors who preferred to give the drug in their office: “I think their concern there is that if this drug is in the wrong hands, it could be used for coercion,” he said.

Mr. Cassidy closed the hearing with a direct request: to change the policy back to what it was in the first Trump administration and require an in-person visit.

The F.D.A. has a staff of about 18,000 and a budget of about $7.2 billion. The agency has vast regulatory authority over products that include prescription and over-the-counter drugs, medical devices, tobacco and about 80 percent of the food supply. It also regulates artificial intelligence software used to scan medical images, an area where the agency has been dismissed as too permissive in its approvals.

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If confirmed, Dr. Makary would first encounter tensions among staff members, who have been whipsawed by the Trump administration’s aggressive measures to reshape the federal bureaucracy in recent weeks.

The staff endured an initial round of about 700 layoffs, decimating some product-review teams that ensure the safety of medical devices such as surgical robots and systems that deliver insulin to people with diabetes. Those firings were followed by some job reinstatements, though many of those in the tobacco division who review the safety of new products and lost their positions, were not called back.

Asked about the layoffs, Dr. Makary said he supported efforts to increase efficiency and that he would review recent personnel decisions.

Pam Belluck contributed reporting.

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Contributor: How federally funded research saved my son's sight — and his life — from a rare cancer

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Contributor: How federally funded research saved my son's sight — and his life — from a rare cancer

If you want to make this country great, imagine the strength of a nation whose children have been fought for and know they have been fought for.

Last month, my son reached two years in remission from a rare, malignant cancer that almost took his eye and his life. He is alive, well and enjoying 20/20 vision because of a groundbreaking treatment that was pioneered by National Institutes of Health researchers, among others, and funded by the government grants the Trump administration is blocking and threatening to cut. If the president continues on this course, children diagnosed during and after this administration will needlessly fare worse than those who came before.

My son Jack was diagnosed in 2022 with retinoblastoma, a malignant childhood cancer of the central nervous system that originates and grows in the eye. If left untreated, it typically migrates through the optic nerve to the brain, eventually metastasizing and taking the life of the child.

Because the cancer usually attacks children under the age of 3, its victims are often unable to report the symptoms of a mass blocking their vision until it’s too late to treat with procedures that can salvage the eye. That’s when enucleation — removal of the eye — is required.

This is why pediatricians developed standard screening for retinoblastoma starting at birth. This now-routine preventative care has enabled medical professionals to find and treat most cases without a loss of vision or life. Because of these developments and others, retinoblastoma has a very high survival rate in 21st century America.

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Jack’s was one of very few documented diagnoses with retinoblastoma after the age of 8. His oncologist suggested his tumor had been hiding in a dark corner of his retina for years, out of his vision and that of physicians; other doctors thought it had “self-arrested” or presented late and grew rapidly. We discovered it only because it burst from the impact of a belly flop at the neighborhood pool, spewing cancer cells in a constellation of poison floating inside his still-intact eyeball, visible to Jack as spots that didn’t go away.

It took weeks for doctors to nail down the diagnosis. When we walked out of that appointment on a day that was so windy I had to hold onto my dress, I put Jack in the car, turned the radio on for him, closed the passenger door and walked about 30 feet away to scream in the parking lot. “My baby!” I wailed through the phone to my mother.

It was an advanced-stage tumor, complicated by the release of cancer cells inside his eye. They could now attach and grow anywhere within — including the optic nerve, with its direct connection to his brain — if we didn’t act quickly. We might have just days before it was too late.

“We could remove his eye,” our oncologist offered at first, “and even that might not be enough.”

Medical researchers from universities and the National Institutes of Health rally near the Health and Human Services Department’s headquarters in Washington.

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(John McDonnell / Associated Press)

Then he explained that we could try to save his eye with a highly advanced procedure called intra-arterial chemotherapy, or IAC. It involves threading a catheter through the thigh’s femoral artery, behind the heart through the carotid artery and into the skull. An interventional radiologist, guided by MRI, releases the chemotherapy agent directly into the artery feeding the retina. This allows doctors to deliver more aggressive and targeted medicine to the diseased cells and limit damage to the healthy ones.

Our oncologist explained that IAC is still a very new technology but one with extraordinary promise whose benefits far outweighed the risks for Jack.

My son underwent six rounds of intra-arterial chemotherapy and seven rounds of intravitreal chemotherapy, in which the medicine is injected directly into the eye. He went under anesthesia 13 times in six months, required monthly breathing treatments that made him spit gray foam, and lost most of the brow and all the lashes around the affected eye. His list of drugs included ketamine, propofol, hydromorphone, melphalan, fentanyl, topotecan, pentamidine, albuterol, prednisolone and aldosterone. At one point, he needed epinephrine because he nearly went into cardiac arrest. Toward the end of his treatment, he received cryotherapy to kill the base of the tumor and woke up from surgery in so much pain that he gritted his teeth to the point of cracking one.

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At every turn, my family was reminded of our privilege — to live in a country that was scientifically advanced enough to have developed such miracle treatments, to live in a city (Denver) with such good hospitals, to have good health insurance through my husband’s employer. If we had lived without such access to care, in a country lacking our resources or just 15 years earlier, our story would have ended differently. Instead, nine months after his diagnosis, thanks to the advanced research our country has supported socially, academically and financially, my son’s cancer was in remission.

My family recently attended a gathering with other retinoblastoma survivors, from toddlers to adults who had conquered the disease decades earlier. As each survivor entered the conference, it became evident that this was once primarily a disease of blindness: The price of survival was generally a loss of sight and eyes. Some of the older survivors had facial abnormalities from radiation or enucleation. Some had canes or family members to guide them. When we told the group that Jack’s body, vision and dream of becoming a pilot were all still intact, many gasped in awe that the science had advanced so far.

But now the Trump administration’s lack of empathy threatens other children and families facing such horrific diagnoses. Continuing research on intra-arterial chemotherapy and other treatments at the University of Colorado’s Anschutz Medical Campus, where Jack was treated, is paid for by programs in the administration’s crosshairs. “These cuts to NIH funding jeopardize the foundation of our life-saving research,” a university spokeswoman told Chalkbeat Colorado. “Reduced research capacity means fewer scientific discoveries, job losses and delayed advancements on therapies and cures that could improve — and save — lives.”

I wonder whether our hospital will be able to continue offering groundbreaking treatments should Jack face a recurrence. And will the newly diagnosed have the same access to care that we did? What greatness can be celebrated when a mother fears she will lose her child’s access to lifesaving treatment?

My son’s recovery was a direct result of the greatness of our country and its past leaders, who had the foresight to pursue progress and excellence in science and refuse to accept losing children without a fight. Because of it, I believe my son will someday fly planes. And I can only hope the next child who faces a dire disease will get the same chance he did.

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Dayna Copeland is a writer and teacher in Colorado.

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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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