A Long-Term Care Crisis for Latino Seniors in California’s Central Valley

For older adult Latinos across California’s rural Central Valley, long-term care is more than a healthcare service — it is a lifeline. It allows our parents and grandparents to age with dignity, surrounded by familiar communities, culture, and family. Today, that lifeline is no longer merely threatened — it has been compromised.

As of January 1, 2026, changes to the Medicare Part D drug pricing schedule officially took effect. The deadline has passed. Without corrective action, these reforms now risk triggering a long-term care crisis across rural California, with Latino seniors among the hardest hit.

While senior advocates strongly support efforts to lower prescription drug costs, the new pricing model has produced serious unintended consequences. Industry analyses indicate that as many as 60 percent of long-term care (LTC) pharmacies could be forced to close at least one location under the new reimbursement structure. In rural regions, even a single closure can be devastating — and now those closures are no longer theoretical.

The impact will be felt most acutely in counties such as San Joaquin, Stanislaus, and Sacramento, where Latino seniors are aging rapidly and healthcare infrastructure is already stretched thin. Rural communities do not have the luxury of multiple pharmacy providers. In many areas, one LTC pharmacy serves dozens of nursing homes and assisted living facilities spread across vast geographic distances.

LTC pharmacies are not retail drugstores. They provide around-the-clock medication management, patient-specific packaging, regulatory compliance support, and direct delivery to care facilities — 24 hours a day, 365 days a year. These services are essential for nursing homes to meet federal safety standards and protect medically fragile residents. Retail pharmacies are simply not equipped to absorb this role, particularly for patients with complex and chronic conditions.

When an LTC pharmacy shuts down, the consequences ripple outward. Nursing homes may struggle to meet legal requirements and could be forced to limit admissions or close altogether. In California, that could mean nearly 10,000 rural seniors suddenly left without access to long-term care. Families would face impossible choices: relocating loved ones far from their communities or attempting to provide care without adequate support.

Nationwide, more than five million Medicare beneficiaries rely on long-term care services, and one in four resides in a facility served by an LTC pharmacy. These patients are among the most medically vulnerable — managing dementia, chronic illness, and mobility limitations. They cannot simply “switch pharmacies,” even if a retail alternative were available.

There is still a path forward — but it now requires retroactive action. H.R. 5031, a bipartisan bill before Congress, would establish a modest $30 flat fee for each Medicare Part D drug dispensed by an LTC pharmacy. This targeted fix would offset revenue losses caused by the new pricing model, stabilize LTC pharmacy operations, and preserve prescription drug savings for seniors.

With the January 1 deadline behind us, Congress — or the Trump Administration through administrative authority — must now act to retroactively address the damage already underway. Failure to do so risks a slow-motion collapse of rural long-term care, disproportionately harming Latino seniors who helped build our agricultural communities and now deserve security and care in their later years.
The time for warnings has passed. Action must follow.
Our national leaders must move swiftly to pass H.R. 5031 — and protect long-term care for Latino seniors in California’s Central Valley.