Op-Ed: I promised to fight for common-sense policies rooted in our core conservative principles
When I ran for office, I promised that I would fight for common-sense policies rooted in our core conservative principles. That means protecting our citizens and ensuring that we keep the good-paying jobs that sustain our communities. Right now, I'm concerned about how upcoming changes to Medicare Part D reimbursement will affect long-term care pharmacies in our state.
Here's why these matters: In North Carolina, over 160,000 beneficiaries of Medicare Part D have long-term care needs, meaning they live with chronic diseases or illnesses and can no longer fully care for themselves. These residents depend on the state's 54 specialized LTC pharmacies to manage their complex medication regimens which can average 12-13 prescriptions daily per person.
Now, you might be thinking, "What's the difference between these pharmacies and the one I go to?" It's a fair question. Long-term care pharmacies are fundamentally different from the retail pharmacies most of us use. These pharmacies mainly serve nursing homes and assisted living facilities, providing round the clock emergency medication access. They deliver medications across long distances, manage specialized packaging, and handle the complex medical needs of long-term care patients. They also help nursing homes and assisted living facilities stay in compliance with federal law that requires these facilities to have pharmaceutical services.
But starting January 1, 2026, many of North Carolina's long-term care pharmacies will face a serious threat to their financial viability due to changes in Medicare Part D reimbursement. The Biden Administration's Inflation Reduction Act directed the federal government to negotiate prices of certain high-cost brand-name drugs directly with drug companies. The promise was lower drug prices for seniors. And while I support efforts to lower drug costs, the law failed to account for its impact on the pharmacies that actually dispense these medications.
Here's the problem: Long-term care pharmacies rely on these well known named medications as well as lesser known medications and they depend on both. When you eliminate that margin, these pharmacies won't be able to keep their doors open and serve the patients who need their specialized care.
And here's the reality—current reimbursement structures simply don't adequately pay these pharmacies for what it actually costs to provide full time day in and day out care, manage complicated prescription loads, and serve patients across North Carolina's rural areas. Without proper compensation, these pharmacies will be forced to shut down.
Let me be clear about what happens when a long-term care pharmacy closes. It's not just an inconvenience—it triggers a cascade of closures and failures. Nursing homes lose their ability to comply with federal regulations and end up closing. Seniors are forced to relocate far from their families and the facilities and communities they know. And good-paying jobs for pharmacists, technicians, nurses, and care staff disappear from our communities.
Consider this, in rural areas where a single pharmacy may serve multiple facilities across several counties, just one closure affects the whole web of care.
That's why we need immediate action—whether through legislation or administrative measures—to protect seniors' access to the pharmacy care they depend on. I strongly support the Preserving Patient Access to Long-Term Care Pharmacies Act (H.R. 5031) as a critical step toward solving this problem.
This bill was introduced by Representatives Beth Van Duyne (R-TX) and addresses this challenge by establishing a targeted supplemental supply fee for prescription drugs subject to Medicare-negotiated prices. Modeled after an existing Medicare Part B supply fee, this solution will help ensure long-term care pharmacies are properly compensated so they can continue delivering the round-the-clock, specialized care that vulnerable patients rely on.
I'm calling on Congress and the Administration to act quickly—either through this legislation or by using the statutory authority CMS already has through a demonstration project or waiver program—to prevent a crisis in long-term care pharmacy access.
This is about protecting our most vulnerable neighbors and preserving good jobs in our communities.
Rep.Cody Huneycutt
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