Op-Ed: The MFN Rule Threatens Our Communities, Our Pharmacies, and Our Health Equity (Chicago, IL) — The health and prosperity of our communities are deeply intertwined. When policy proposals threaten the lifeblood of underserved neighborhoods—our small businesses, local pharmacies, and access to affordable care—we must speak out. The proposed inclusion of the Most Favored Nation (MFN) pricing model in Medicaid is one such threat. If implemented, this policy would disproportionately harm Black and Brown communities across the Greater Chicagoland area and beyond, while destabilizing the small businesses that serve them.
At first glance, the MFN model seems like a noble effort to reduce drug prices by tying U.S. prescription costs to those in other developed nations. But in practice, it is a blunt instrument that ignores the intricacies of our healthcare system and the unique challenges faced by minority-owned small businesses and the patients they serve.
Independent Pharmacies at Risk
Independent pharmacies are more than just places to fill prescriptions—they are trusted, often multigenerational institutions that provide culturally competent care, job opportunities, and economic stability in neighborhoods that large retail chains often ignore. In many South and West Side communities, these pharmacies are the only accessible point of care.
The MFN model threatens their very existence. By pegging Medicaid drug reimbursement rates to the lowest prices paid abroad, many independent pharmacies would be forced to dispense medications at a financial loss. They cannot negotiate drug prices at the scale of large pharmacy benefit managers or national chains. With already razor-thin margins, these small businesses could be pushed to the brink, leading to closures, layoffs, and a collapse in local access to care.
A Blow to Underserved Populations
What happens when independent pharmacies disappear? Our communities lose essential health services. Elderly residents on fixed incomes must travel further for their prescriptions. Working parents lose after-hours access to pharmacists who know their families. Chronic disease management—already more challenging in underserved populations—becomes even more fragmented and inaccessible.
For Medicaid recipients in Black and Brown communities, the MFN model could lead to delayed treatments, reduced medication availability, and serious health consequences. It is a policy built for budget sheets, not people.
The Innovation Pipeline in Peril
Pharmaceutical companies—particularly small or mid-sized firms—also face headwinds under this proposal. If they are forced to sell breakthrough therapies at internationally benchmarked rates that don’t reflect the U.S. market’s development costs and regulatory burdens, they may shift focus away from high-risk, high-need therapeutic areas like sickle cell disease, which disproportionately affects African Americans. The MFN model could inadvertently stifle innovation where it is most needed.
A Better Path Forward
We all want lower drug prices. But there are better ways to achieve that goal—ways that don’t devastate local pharmacies, restrict access to care, or discourage innovation. Real reform requires transparency in the pharmacy benefit manager system, smarter drug negotiation strategies, and investment in community-based healthcare delivery.
The Greater Chicagoland Black Chamber of Commerce urges lawmakers to reject the inclusion of the MFN model in Medicaid policy. Instead, we call for thoughtful, equitable solutions that support—not sacrifice—the pillars of health and economic well-being in underserved communities.
Let us not balance budgets on the backs of our most vulnerable.
Op-Ed: The MFN Rule Threatens Our Communities, Our Pharmacies, and Our Health Equity
