Science
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.
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.”
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.
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.
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.
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.
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.
Science
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.
Rising insurance costs are eating into household budgets.
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.
Home insurance costs have soared where climate hazards are highest.
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.
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?
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.
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.
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.
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.
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.
Science
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.
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.
“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.
Science
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.
Similar increases are hitting homeowners across the state, where insurance costs have exploded over the past four years.
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.
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.
“They won’t insure you,” Ms. Rojas said. “No one will buy from you. You’re kind of stuck where you are.”
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.)
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.
“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.
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.
“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.
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.
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.
“Now, we’ve got to take the gamble,” Mr. Guidry said.
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.
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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