OPINION:
There is a quiet rhythm in rural America you will not find anywhere else. It is the sound of gravel under your boots instead of the constant hum of a concrete jungle. It is the fresh, earthy smell that rises after a summer storm, not the musty haze of city streets. Out here, the horizon is wide, the air is clear and our values run deep. Hard work is not a slogan, but a way of life, a handshake and a person’s word are still as binding as any contract.
This is the America I know. This is the America that has shaped me.
Representing Nebraska’s Third District 80 of Nebraska’s 93 counties and nearly 70,000 square miles means representing the middle of America’s heartland. It means fighting for the people who feed and fuel our nation, who show up early, stay late and take care of their neighbors without being asked. It is an honor I never imagined, growing up nearly 1,600 miles from the halls of Congress, but it is one I carry with deep gratitude.
And because I represent a vast, rural district, I see clearly what challenges threaten the next generation’s ability to live, work and raise a family. One of the greatest of these being access to healthcare.
In rural communities, distance is more than an inconvenience; it can be dangerous. When there is no Walmart for hundreds of miles, resourcefulness becomes a necessity. But when the nearest clinic or hospital is that far, resourcefulness alone is not enough. For many seniors, the barriers for accessing healthcare can be overwhelming. Long drives for a simple flu test can mean delaying care or hoping it just goes away. And when it comes to respiratory illnesses, a delay in testing often means a delay in treatment and worse outcomes.
Pharmacists are the most accessible healthcare professionals in America. Nearly nine in ten Americans live within five miles of a pharmacy. In rural communities, pharmacists often serve as the first point of care. They fill gaps in our healthcare system every day, offering trusted advice, quick testing and timely treatment.
But here is the problem: A person might get tested and treated for several common respiratory illnesses by their community pharmacist their entire life. But the day that person turns 65 and enrolls in Medicare, they can no longer go to the pharmacist for those services Medicare doesn’t cover those services when provided by a pharmacist. Private insurance covers it. Medicaid covers it. Medicare does not. Sadly, many seniors find out about this lack of coverage when they are sick at the pharmacist’s counter, forced to go somewhere else to receive care.
This is not just illogical. It also leaves seniors in rural America with fewer options and longer drives for basic care. Fortunately, I introduced the Main Street Pharmacy Access Act to solve this discrepancy.
My bill takes a practical, targeted approach to fixing a real problem. It allows Medicare to reimburse pharmacists for testing and treating common respiratory illnesses just as private insurance and Medicaid already do. Importantly, it does not change scope of practice. States remain fully in control of what pharmacists are allowed to do. My bill just says this: If a state allows pharmacists to provide these services, Medicare should cover them.
This is about access. This is about fairness. This is about making life easier for seniors who have spent their lives contributing to our communities.
I am grateful my Main Street Pharmacy Access Act passed out of the Ways and Means Committee by voice vote. This bipartisan support reflects what I hear across my district: people want solutions that work. I look forward to working with my colleagues to get this bill passed and signed into law.
I will continue fighting for rural America because it is where I grew up, it is where I have chosen to raise my family, and it remains one of the greatest strengths of our nation. Strengthening rural communities strengthens America itself, and I am committed to ensuring that the next generation can thrive in the same wideopen, valuesdriven places that have shaped our nation.
• Rep. Adrian Smith represents Nebraska’s 3rd Congressional District. He serves as chairman of the Trade Subcommittee on the House Ways & Means Committee, and is also a member of the subcommittee on Health.
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