If you live in a state where medical marijuana use has been legalized, you might assume that healthcare will cover medical marijuana when used like other medicines. Unfortunately, that is currently not the case. Health insurance does not pay for medical marijuana, even in states where its use has been legalized. However, news out of New York and New Mexico hint at potential changes to come.

New York Senate moves to approve medical marijuana healthcare

In early June, the New York Senate approved a bill requiring public health insurance programs to cover medical marijuana expenses. It also clarified that private insurers are allowed to do the same. SB S8837 would amend state public health and social services statutes to address one of the most significant barriers to patient access to medical cannabis: the out-of-pocket cost of the medicine.

It would achieve that by defining medical marijuana as a “prescription drug,” “covered drug” or “health care service” under the relevant codes. This would mean that public health insurance providers, including Medicaid and workers compensation, would be mandated to provide coverage. For private, commercial insurers, however, cannabis coverage would be optional.

What does this mean for patients?

cannabis healthcare legislation

This would be a monumental step for the industry, and would greatly improve access, particularly for low-income patients who have begun treatment with cannabis and ultimately stopped due to unaffordable price points. Even in markets where medical cannabis is taxed at a much lower rate than recreational use, this medicine can still be very costly to the patient.

Having insurance supplementation would be a game-changer for many patients who need this medicine, while also trying to make ends meet. If enacted, the bill would bring changes to public health programs as well, like Medicaid, Child Health Plus, Elderly Pharmaceutical Insurance Coverage (EPIC), Essential Plan programs and workers compensation.

How fast will healthcare legislation change?

We know these changes take time. If SB S8837 passes in the Assembly and is signed by the governor, the bill would take effect starting next April. But this year the normal legislative session is already over, meaning it will likely need to be reintroduced unless it’s brought up in a special session.

Outside of New York, the largest marijuana company in New Mexico pushed to have insurers cover medical cannabis expenses earlier this year. Though the company said it required by law, so far that effort has not made a policy change.

Looking towards the future of the cannabis industry, hope remains that as regulations evolve at the federal level, potential insurance supplementation could come into play. If, and when this is implemented remains to be seen, but this could certainly send shockwaves to the cannabis industry.

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