Op-ed: Support long-term care pharmacies to keep our seniors safe and healthy

DATE: November 7, 2025

By Bryan Posthumus | Published November 6, 2025

Seniors in Michigan rely on long-term care (LTC) pharmacies to manage the complexity of their medical needs. Averaging 12-14 medications daily, patients need the reliable and specialized services offered by LTC pharmacies. Nowhere is this more important than in Michigan’s rural areas, where nearly 20,000 seniors on Medicare Part D have long-term care needs.

Unfortunately, as of Jan. 1, 2026, we could be facing a devastating reality where LTC pharmacies will close their doors due to changes in Medicare Part D reimbursements. The Biden Administration’s Inflation Reduction Act allowed the federal government to negotiate directly with drug companies on higher priced brand-name drugs. However, this law did not account for the unique business model of LTC pharmacies, which depend on the reimbursement structure for brand-name medications to subsidize the comprehensive services they provide to nursing home residents.

This isn’t about making large profits — it’s about sustaining essential services. These costs are essential to supporting the complex operations of LTC pharmacies such as providing 24/7/365 service, delivering medications over vast distances, and managing the prescriptions of patients in need of long-term care.

State Rep. Bryan Posthumus (R- Cannon Twp.)
The financial model is straightforward but precarious. LTC pharmacies lose money on most generic medications. To offset these losses, they rely on the reimbursements from brand-name drugs. Unfortunately, the new negotiated prices reduce reimbursement on brand-name medications. Critically, eight of the 10 drugs subject to these price reductions are among the most commonly prescribed in long-term care settings.

These newly negotiated prices will eliminate the revenue stream that allows LTC pharmacies to break even while providing services that retail pharmacies simply don’t offer. In the absence of this income, LTC pharmacies will be forced to close their doors and with that, leave nursing homes and senior living facilities without their services.

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In rural areas, this is particularly concerning. There may only be one LTC pharmacy within an appropriate distance. If it closes, so too will the nursing home and assisted living facilities that need access to it to be compliant with federal regulations. Nursing homes cannot just switch to using retail pharmacies as they do not offer the specialized services required to give seniors in need of long-term care the appropriate and compassionate care.

Thankfully, our federal government has an opportunity to stop this devastating domino effect. H.R. 5301, the Preserving Patent Access to Long-term Care Pharmacies Act would create a temporary two-year $30 supply fee per prescription under the newly negotiated Medicare prices. This fee will help alleviate the financial stress of LTC pharmacies and ensure they can continue providing their essential and life-saving services. In addition, the Trump Administration can use the CMS’s statutory authority to institute a demonstration project or waiver program to alleviate the impending financial strain.

As the new year rapidly approaches, we must act quickly to save LTC pharmacies. In Michigan, we have a growing elderly population with 45 of 83 of our counties having more seniors than children. In my district — the 90th House District in Northeast Kent County—rural communities like Sparta, Courtland, and Grattan face the same challenge: an aging population that depends on LTC pharmacies for survival. We owe it to them to ensure our healthcare system can support their medical needs.

I call on the Michigan federal delegation and the Trump administration to embrace these lifesaving fixes quickly and ensure that LTC pharmacies can continue doing the work to keep our seniors safe and healthy.

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Bryan Posthumus represents Michigan’s 90th District in the Michigan House of Representatives.