Op-ed: Rural seniors in California are facing a healthcare crisis. Congress must act now

DATE: November 5, 2025

By Ronnie Janson | Published November 5, 2025 in Mountain Democrat

As a professional advisor with over a decade of experience specializing in the financial security of California’s elderly, especially in rural communities, I feel compelled to sound the alarm on an imminent crisis that threatens the very foundation of long-term care in our state. Unless Congress acts swiftly, thousands of Californians could lose access to vital pharmaceutical services and long-term care.

This crisis stems from impending changes to Medicare Part D drug pricing, set to take effect on Jan. 1, 2026. While I support the worthy intentions of reforms to reduce prescription drug costs, these same reforms unintentionally put long-term-care pharmacies at risk. As many as 60% of LTC pharmacies could be forced to close at least one of their locations due to the new pricing model.

This could have catastrophic consequences, especially for rural seniors — especially those in El Dorado County.  

LTC pharmacies do far more than fill prescriptions. They provide a full suite of services that no retail pharmacy can match: 24/7/365 medication management, patient-specific packaging, and medication delivery. Nursing homes and assisted living facilities depend on these pharmacies to comply with federal requirements for safe, timely pharmaceutical care.

Nowhere is this interdependence more critical than in California’s rural regions. One LTC pharmacy may serve dozens of facilities spread across vast areas. If that pharmacy were to shut its doors, the ripple effects would be devastating. Nursing homes may be forced to close because they can no longer meet their legal obligations to residents. The result? In California, this means that the nearly 10,000 seniors in rural areas with LTC needs are unable to access the services they currently depend on. 

More than five million Medicare beneficiaries rely on long-term care, and one in four reside in a facility that utilizes LTC pharmacies. These patients are among the most medically vulnerable — individuals living with multiple chronic conditions, cognitive impairments or mobility limitations. They cannot simply switch to a local retail pharmacy. In many cases, there isn’t one within driving distance, and even if there were, retail pharmacies aren’t equipped to provide the high-level services these patients require and only LTC pharmacies can fulfill.

Fortunately, there is a solution — and time is of the essence.

HR 5031, a bipartisan bill currently before Congress, would create a modest $30 flat fee for each Medicare Part D drug dispensed by an LTC pharmacy. This fee would offset the revenue shortfalls created by the new drug pricing system, ensuring that LTC pharmacies can continue providing essential services. Importantly, this solution preserves drug cost savings for seniors while stabilizing the infrastructure required to deliver them.

Without action, we risk triggering a healthcare collapse in California’s rural communities. We risk leaving our most vulnerable neighbors without access to medications, care, or the dignity they deserve in their later years. 

Pass H.R. 5031 and protect long-term care for the seniors.

Read the full article on the Mountain Democrat here