Op-ed: California Seniors Face a Looming Long-Term Care Pharmacy Crisis—Congress and President Trump Can Fix It

DATE: October 27, 2025

Every day across California, seniors depend on long-term care (LTC) facilities and the specialized pharmacies that keep them healthy, safe, and stable. These LTC pharmacies are a lifeline—providing not just prescriptions, but clinical oversight, 24/7 medication delivery, patient-specific packaging, and consulting pharmacists who ensure that complex medication regimens are accurate and effective.

But that lifeline is now at risk.

If Congress and the Trump Administration fail to act soon, as many as 60% of LTC pharmacies could be forced to close due to unintended consequences from the Inflation Reduction Act’s (IRA) Medicare drug pricing changes that take effect in 2026. This is not speculation—it’s math. LTC pharmacies depend on Medicare Part D for about 80% of their business, and the IRA’s “Maximum Fair Price” policy didn’t account for how these pharmacies are reimbursed for essential services.

Negotiated prices for the first 10 prescription drugs go into effect on January 1, 2026, drastically altering how LTC pharmacies are reimbursed and creating unsustainable financial challenges. Eight of those first ten drugs are commonly prescribed to long-term care patients, concentrating the impact where seniors are most vulnerable—inside skilled nursing facilities and assisted living communities. Without an urgent fix, many pharmacies will no longer be able to provide the services federal law requires nursing homes to deliver.

Here in California, the consequences would be devastating. Rural counties like Tulare, Mendocino, and Siskiyou often rely on a single LTC pharmacy to serve dozens of facilities. If that pharmacy closes, seniors lose access to legally mandated pharmaceutical services—and facilities risk closure for noncompliance. The ripple effects would be enormous: seniors left without care, caregivers and nurses out of work, and communities stripped of critical healthcare infrastructure.

That’s why I, along with the Healthcare Advocacy Coalition of California, am urging Congress to pass H.R. 5031 – the Preserving Patient Access to Long-Term Care Pharmacies Act. Introduced by Representatives Beth Van Duyne (R-TX) and Brad Schneider (D-IL), this bipartisan legislation provides a simple, targeted solution. It creates a $30 supply fee for each Medicare drug subject to negotiation when dispensed by an LTC pharmacy—ensuring these pharmacies can continue serving seniors without new taxpayer spending. This policy is not about politics—it’s about protecting the health and dignity of older Americans.

California’s 6 million seniors deserve uninterrupted access to the medications and expert care they depend on.

But time is short. With new drug prices taking effect in 2026 Congress must act before year’s end. And while the legislative process moves forward, I also urge the Trump Administration to consider an administrative fix—a temporary measure that would stabilize the system until Congress finalizes the long-term solution.

Protecting long-term care pharmacies means protecting seniors, preserving jobs, and ensuring that our nation’s most vulnerable citizens receive the care they deserve. California’s seniors—and the families who love them—need action now, not after the crisis has begun.

Read the full article on the Sacramento Daily Press here