Michigan lawmaker urges Congress to shield long‑term care pharmacies from Medicare drug cuts

Lansing, MI — A Michigan state lawmaker is pressing Congress to act quickly on a bipartisan bill he says would protect long-term care pharmacies from being squeezed by federal drug price reforms — a financial hit he warns could shutter providers and disrupt care for thousands of older residents.

In a local opinion column published Thursday, Rep. Bryan Posthumus, a Michigan House Republican, called for passage of the so-called “LTC Pharmacy Fix,” federal legislation that would carve out long-term care (LTC) pharmacies from certain Medicare Part D price concessions. He argues the change is needed to keep these specialized providers viable as Medicare’s new drug price negotiations take effect.

“Seniors in Michigan rely on long-term care pharmacies to manage the complexity of their medical needs,” Posthumus wrote. “Without them, we risk a crisis in elder care.”

What’s at stake for nursing homes

Unlike retail drugstores, LTC pharmacies operate around the clock and are built to handle complex medication regimens in nursing homes and assisted living communities. They provide unit-dose packaging, clinical oversight by consultant pharmacists, and rapid delivery for urgent orders — services that advocates say reduce errors and hospitalizations among frail residents.

Industry groups estimate the average long-term care resident takes roughly a dozen medications each day, heightening the risk of adverse drug interactions. Michigan has hundreds of nursing homes and assisted living communities, and more than 40,000 people living in nursing facilities, according to state data. Providers say disruptions to LTC pharmacy services would be particularly hard on rural areas with limited alternatives.

Pressure from Medicare drug negotiations

The Inflation Reduction Act directs Medicare to negotiate prices for select high-cost medications, with the first negotiated prices scheduled to take effect in 2026 and expand in subsequent years. LTC pharmacy operators say they have thinner margins than retail pharmacies and cannot absorb additional price concessions tied to Part D without cutting services or closing locations.

An industry study released late last year projected a significant share of the nation’s LTC pharmacies could face closure within a few years if no changes are made, potentially raising medication error rates and sending more residents to hospitals. Advocates also warn that nursing facilities would face higher costs and staffing strains if they are forced to piece together medication services from retail channels not designed for institutional care.

Federal officials note the broader goal is to lower out-of-pocket drug costs for Medicare beneficiaries. In congressional testimony last year, the head of the Centers for Medicare & Medicaid Services said the agency is open to administrative adjustments for vulnerable populations, while emphasizing that any comprehensive carve-out would likely require action by Congress.

Push for a federal fix

The House bill, introduced by Reps. Beth Van Duyne (R-Texas) and Claudia Tenney (R-N.Y.) with backing from members of both parties, would exempt LTC pharmacies from certain price concessions under Part D. Supporters — including senior advocates and long-term care pharmacy organizations — say the measure is a targeted correction to prevent unintended fallout from the drug negotiations.

“This isn’t just a pharmacy issue — it’s a threat to the health and dignity of our seniors,” Posthumus wrote, urging Michigan’s congressional delegation to support the bill in the current session. Advocacy groups in the state have also called for swift action, saying families cannot afford disruptions to medication access and oversight.

What comes next

The first wave of negotiated Medicare prices is slated to begin in 2026, leaving a narrow window for any legislative fix. If Congress advances the proposal, LTC pharmacies would still be subject to most Medicare rules but could be insulated from the price concessions that operators say are uniquely destabilizing to their model.

For now, nursing home leaders say they are preparing contingency plans — from contracting with multiple suppliers to expanding in-house checks — while warning that such workarounds are costly and carry risks. The debate is likely to intensify in the weeks ahead as Congress weighs whether to adjust drug policy in order to preserve the specialized pharmacy backbone that many facilities rely on every day.