LTE: Policy Change Will Shut Down LTC Pharmacies

DATE: December 20, 2025

By Donna Manning | Published December 20, 2025 in The Idaho Press Tribune

Having worked in the healthcare arena, I learned that good policy requires understanding medical service delivery. A federal policy change could cause a crisis for Idaho’s vulnerable seniors, including my neighbors and me in Council.

Starting January 1, 2026, a new Medicare drug price policy will make it impossible for specialized long-term care (LTC) pharmacies to operate. These pharmacies serve residents in nursing homes and assisted living, managing multiple medications daily. Staff packages doses, delivers to facilities, trains caregivers, and coordinates with doctors on prescriptions.

The Inflation Reduction Act of 2022 aimed to lower drug prices but overlooked LTC pharmacies, which rely on sufficient reimbursement to cover their intensive services. Unlike retail chains that offset lower margins with volume, LTC providers depend on adequate reimbursement. In rural Idaho, 21,789 Medicare seniors risk losing access to care. When alternatives are an hour away, facilities can’t manage daily medication through distant pharmacies. These aren’t monthly prescriptions.

The solution exists. H.R. 5031 would create a modest service fee for affected medications in 2026-2027, buying time while Congress develops a long-term fix. This would be similar to successful legislation from 2003 and has support across the healthcare spectrum. President Trump’s administration could offer immediate relief via regulatory action, a CMS waiver, or similar measures, as Congress finalizes permanent legislation.

I know our congressional delegation understands the stakes, but understanding isn’t enough. We need action before January 1; otherwise, Idaho care facilities might not meet their responsibility to deliver medications safely and on time.

Read the full article on The Idaho Press Tribune here