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Kimberly Lindlof is president and CEO of the Mid-Maine Chamber of Commerce.
I’ve long been an advocate for growing our business community in a thoughtful and sustainable way. What’s often missing from the economic development conversation is health care. Access to affordable, reliable care isn’t just a quality-of-life issue — it’s a business issue. When workers are healthy and families can stay in their communities, employers can grow, jobs can be filled, and local economies thrive. In rural areas especially, a strong health care system is essential infrastructure for economic growth.
That infrastructure is already under strain in rural Maine. Providers are grappling with workforce shortages, rising costs, and reimbursement systems that fail to keep pace, all making it harder to keep doors open and services available. We have lived this firsthand in the greater Waterville area with the shuttering of Northern Light Inland Hospital, leaving thousands without primary care and specialty services.
Now, we are facing an immediate threat to rural health care for Medicare beneficiaries. This month, 60% of long-term care (LTC) pharmacies across the country may be forced to close. These pharmacies primarily serve people with complex medical needs, often residents of nursing homes or assisted living facilities, who may take a dozen or more medications each day and require careful coordination and strict prescription management.
LTC pharmacies are the only pharmacies able to meet these needs. They drive to nursing homes and assisted living facilities all over the state, package prescriptions, and liaise with onsite staff. These are services that traditional pharmacies can’t and don’t offer.
But because of the previous administration’s policies, we could witness the collapse of LTC pharmaceutical care, especially in smaller communities and regions with limited health care options. LTC pharmacies are able to cover their specialized services with the reimbursement from brand-name drugs. Newly negotiated prices for these medicines, which went into effect on Jan. 1, cut into these reimbursements. While well-intended to lower prescription drug prices, this policy puts many LTC pharmacies in an insurmountable financial position.
For a nursing home or assisted living facility to be in compliance with federal regulations, they must be able to provide its residents pharmaceutical services — services that only LTC pharmacies can provide. If one of these pharmacies closes, the effects ripple across the system. Nursing homes that rely on it may be forced to shut, particularly in smaller communities where switching to another pharmacy isn’t feasible. Maine has only nine LTC pharmacies, and five of them serve communities with limited access to care.
In real-life terms, that’s residents without a home, care staff without jobs, and pharmacies out of business. In economic terms, it’s projected to cost taxpayers $4.8 billion dollars over the next decade.
As CEO of the Mid-Maine Chamber of Commerce, I know what this looks like — a cascade of economic failures waiting to happen. When a nursing home closes, you lose quality employment. You lose the suppliers who provide food services, linens, and maintenance. You’re losing the economic activity that comes from families visiting their loved ones.
Thankfully, there is still time to prevent a crisis. The administration has the authority to temporarily adjust Medicare rules through an emergency demonstration project or a waiver to keep long-term care pharmacies operating while a permanent solution is put in place. They should use that power and responsibility to act now and prevent closures before they start.
Additionally, there’s legislation in the Senate, the Preserving Patient Access to Long-Term Care Pharmacies Act, that would establish a modest supply fee for prescriptions, giving LTC pharmacies the financial support they need to cover their operating expenses. I urge Sen. Susan Collins to co-sponsor and champion this bill and this cause.
The economics here are straightforward: spend a little now to prevent massive costs later. A small fee per prescription is a fraction of what taxpayers will spend when seniors end up in emergency rooms, nursing homes close their doors, and communities lose essential services.
We have no time to lose. President Donald Trump’s administration can act, and Sen. Collins can lead. Maine seniors, health care staff, and pharmacists are relying on it.
