Op-ed: Trump Administration must act to preserve senior care

DATE: November 29, 2025

By Will Tallman | Published November 29, 2025 in The Sentinel

During my years representing the rural communities of southcentral Pennsylvania, I learned that when a system works smoothly and efficiently, people take it for granted.

That is exactly the case with our long-term care (LTC) pharmacies — the unseen lifeline supporting nursing homes, assisted living facilities and the seniors who depend on them every single day. But today, that lifeline is at serious risk of being severed by a policy disaster created under the Biden administration.

In less than 40 days, a new Medicare Part D pricing policy is set to take effect, and unless federal leaders intervene, it will hit LTC pharmacies with force, especially in rural areas like those that I represented as a state lawmaker.

This looming crisis is a direct result of the Inflation Reduction Act, which directed the federal government to negotiate “maximum fair prices” on certain brand-name, high-cost medications. The intention
of helping seniors better afford prescription drugs is admirable, but Democrats pushed this legislation through Congress without understanding how rural health care actually works.

Unfortunately, some of Pennsylvania’s most vulnerable citizens are about to pay the price, unless drastic action is taken.

LTC pharmacies occupy a unique role in the state’s long-term care system. Unlike your average retail operation, LTC pharmacies manage the health care needs of patients with complex needs, who juggle a
dozen or more medications daily. These prescription regimens require precise packaging, time-sensitive delivery, constant monitoring and coordination with care teams.

Maintaining this level of service demands specialized staff and costly infrastructure – and these specialized services, such as driving long distances to get to rural senior facilities, don’t currently get
reimbursed by Medicare. As a result, LTC pharmacies rely on the reimbursement from brand name drugs to stay afloat.

However, the new Medicare pricing authorized by Biden eliminates this revenue. With it, they eliminate the financial foundation of LTC pharmacies.

The damage will be felt everywhere, but the worse consequences will land squarely on rural Pennsylvania, where 11 out of the 72 LTC pharmacies are currently situated. If one pharmacy is forced to close, senior facilities will instantly lose the pharmaceutical services that are mandated by federal code. Without these services, these facilities cannot remain open.

If these LTC pharmacies collapse, the senior homes they support will follow. And if those facilities close, rural families will have nowhere to turn.

Seniors will be displaced, jobs will be lost and entire communities will be left without long-term care options.

Equally concerning is the projected cost of this change. The Senior Care Pharmacy Coalition, representing 352 LTC operations, estimates that taxpayers could face up to $4.8 billion in increased health care costs over the next decade – a steep price for a policy that was supposed to save money.

Fortunately, this is exactly the problem that we elected President Trump to fix: disasters created by the previous administration that would harm working families and cost taxpayers more money.

President Trump has the power, and responsibility, to act now by delaying or modifying the new drug pricing until a sustainable payment model is identified. He should issue this directive within days, not weeks.

Once executive action stabilizes these pharmacies, Congress can provide additional relief by passing the bipartisan Preserving Patient Access to Long-Term Care Pharmacies Act (H.R. 5031), which would keep LTC pharmacies operational through 2027 until a permanent fix is identified.

But none of this matters if action doesn’t come soon. Once the new year arrives, the clock runs out. Pharmacies will begin to shutter, and rural facilities — the ones with the fewest alternatives — will feel the impact first and hardest.

Pennsylvania’s congressional delegation should champion immediate action and demonstrate that Republicans are cleaning up the mess left behind by Democrats.

I spent years advocating for the people of southcentral Pennsylvania. Even in retirement, I cannot stay silent as a preventable crisis approaches.

Seniors deserve stability, safe care and access to the medications that sustain them. They should not become casualties of a well-intended policy that failed to account for the fragile ecosystem keeping long
term care afloat.

We cannot wait, we cannot look away, and we cannot allow rural seniors to be left behind.

Our aging population is counting on action from Washington.

Will Tallman is a retired state lawmaker who represented the 193rd Legislative District in Harrisburg from 2009 to 2018.

Read the full article on The Sentinel here