I had the honor of caring for my mother through the last years of her life as she fought stage 4 gastric cancer. Her care team consisted of internists, nurses and pharmacists, each leveraging their specialties to ensure my mother received the best care possible. This was a stark difference from our past, where at the age of 10 years, I watched my mother give birth prematurely to triplet brothers in our home in Egypt. The closest medical facility with specialized neonatal care was 300 miles away and financially out of reach for our family. Two of my brothers didn’t survive. 

Being able to provide my mother with the accessible care she lacked as a young mother was the least I could do for her. It also embodied the principle that has guided my entire medical career: access to health care shouldn’t be determined by wealth or geography. 

Today, tens of thousands of Arizonans face a similar crisis of distance and access. In less than a month, changes to Medicare Part D reimbursements could close up to 60% of long-term care (LTC) pharmacies across Arizona and the nation unless President Trump acts immediately. For the 91,965 Medicare beneficiaries in our state who depend on these pharmacies, this isn’t a policy debate — it’s a matter of survival. 

LTC pharmacies are the backbone of care for Arizona’s most vulnerable residents. They serve nursing homes and assisted living facilities across our vast state, including rural communities where a single LTC pharmacy may be the only one serving dozens of facilities within hundreds of miles. These aren’t typical pharmacies — they manage complex medication regimens for patients who may take a dozen prescriptions daily, require specialized packaging, and need round-the-clock pharmaceutical support that federal law mandates senior care facilities must provide to operate. 

This is exactly the kind of preventable crisis rooted in distance and inaccessible care that drove me into medicine. The difference is that this time, we have the power to act before tragedy strikes. 

The Trump administration can offer immediate relief through demonstration projects or waivers — tools already within its statutory authority that require no congressional approval. Following that emergency action, Congress can pass the bipartisan Preserving Patient Access to Long-Term Care Pharmacies Act (H.R. 5031), which would establish a temporary supply fee per affected prescription to keep LTC pharmacies operational while we develop a sustainable funding model for such a necessary (and complex) business.

I’ve traveled thousands of miles and spent decades in medicine guided by a promise I made as a child: No one should lose access to care because of where they live or what they can afford. Arizona’s seniors in long-term care facilities — in Phoenix, Tucson, Flagstaff, and every small town in between — deserve that same promise kept.

That’s why I encourage President Trump to meet this critical moment and act with urgency. 

Dr. John Anwar is the chair of medicine of St. Vincent De Paul / Virginia G. Piper Medical Clinic and an assistant Clinical professor at the Department of Internal Medicine Residency Program at Creighton University School of Medicine.