For Mark Williams, it’s a simple business proposition: He can’t afford to sell medicine for less than what he paid for it.

But he says that’s what Washington expects him to do, come January.

“When I talk to other businesspeople and say that, they look at you cross-eyed, like, `No way,’” said Williams, the pharmacist-owner of the Medicine Shoppe in Kansas City, Kan., for the past 18 years. “But it’s going to happen.”

It’s a common warning from the nation’s community pharmacists, who have been watching their ranks dwindle in recent years. Now they’re looking for help from Congress, fearful that reductions in the amount the federal government reimburses them for Medicaid drugs will drive more of them out of business.

Yet much more than the livelihood of pharmacists is at stake.

If the changes proceed, critics warn, tens of thousands of Americans who depend on Medicaid could be denied life’saving drugs or forced to drive long distances to get them. Medicaid is the federal’state program that subsidizes health costs for 53 million low-income people and those with disabilities.

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