New Hampshire medical expansion bills near passage as recreational legalization also advances

As New Hampshire lawmakers prepare to make the state the 25th state in the United States to legalize recreational marijuana, separate legislation to significantly expand the state's existing medical cannabis program is also moving forward. towards final adoption.

House and Senate negotiators on conference committees reached agreements on the language of the measures before Thursday's deadline. One proposal would allow doctors to recommend marijuana for any condition they believe could be improved through cannabis use, and the other would expand the pool of medical professionals who can recommend medical marijuana.

Both bills now return to each legislative chamber for up or down votes. If they succeed, they will then go to the office of Governor Chris Sununu (R).

The compromises come on top of Thursday's deal on legislation to legalize and regulate marijuana for adults, a deal reached after months of tension between the two chambers over how to approach reform.

Regarding the eligibility requirements bill, HB 1278, conference committee members agreed to follow the version of the bill passed by the House in March, recommending that its language be adopted by both chambers .

“The Senate backed away from its amendment and adhered to the House position,” Rep. Erica Layon (R) wrote in a House conference committee report, “which allows providers to certify adults 21 and older for medical cannabis at their own discretion rather than a limited list of conditions.

Sponsored by Rep. Wendy Thomas (D), a cancer survivor and medical marijuana patient, the bill would add to the state's medical marijuana eligibility requirements “any debilitating or terminal medical condition or symptom for which the benefits potential risks of medical cannabis use would, in the clinical judgment of the provider, likely outweigh the potential risks to the patient's health.

As a medical marijuana patient, Thomas told a Senate committee earlier this year that cannabis helps manage chronic pain, insomnia, eating problems, gastrointestinal issues, PTSD and anxiety.

“I found relief from all of these symptoms,” she said, “some of which are not covered by the program.”

The proposal would not remove the enumerated list of eligibility requirements, which Thomas said is a useful way for clinicians less familiar with cannabis to navigate the system. “The fact is that they would be allowed to…refer a patient to the program for any condition that they think would be suitable and benefit the patient,” she explained.

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The other measure, SB 357, would extend the authority to recommend medical marijuana to any health care provider in New Hampshire “who is authorized to prescribe medications to humans and who has active registration with the State Drug Enforcement Administration -United. [DEA] prescribe controlled substances. These providers should be “primarily responsible for the patient’s care related to their qualifying health condition.”

After that bill passed senators earlier this year, House lawmakers made an amendment to the bill that the Senate later rejected. The final bill uses new compromise language, adjusting a previous version passed by the Senate.

The final version would allow out-of-state physician assistants to certify patients for New Hampshire's medical marijuana program, and it would update an “outdated reference” in the existing section of the physician assistant law , according to a report from the Layon House conference committee. .

As for legislation to legalize marijuana for adults, HB 1633, that proposal would allow 15 stores to open statewide starting in 2026 through a new state-run franchise system. Although the stores would be run by the private sector, the government would oversee operations, including setting final product prices. Purchases would incur a 15 percent “franchise fee” — effectively a tax — that would apply to both adult-use and medical marijuana purchases.

Marijuana possession won't become legal until 2026, once the state's licensed market is operational. That same year, possession of up to two ounces of marijuana would become completely legal. Meanwhile, possession of one ounce of cannabis would be punishable by a maximum civil fine of $100.

Home cultivation of cannabis for personal use would remain illegal and the State Liquor Commission would have the authority to enforce this provision.

“The House was able to secure some concessions from the Senate, which include edibles in automobiles for passengers, thereby increasing the current law's possession from 3/4 of an ounce to 1 [ounce]” wrote Rep. John Hunt (R) in the House conference committee report, along with “changing the date medical marijuana providers become for-profit and an additional ATC member for the supervisory commission”.

Sununu previously said he would accept legislation based on the version of the bill passed by the Senate, provided House lawmakers don't make major adjustments. His office did not immediately respond to a request for comment sent Thursday.

New Hampshire lawmakers worked extensively on marijuana reform issues last session and attempted to reach a compromise to enact legalization through a tiered system that would include state-controlled stores, dual licensing for existing medical cannabis dispensaries and private businesses licensed to individuals by state agencies. . The legislature ultimately reached an impasse on this complex legislation.

Bicameral lawmakers also convened the state commission last year to study legalization and propose a path forward, although the group ultimately failed to reach consensus or propose final legislation .

The Senate last year rejected a more conventional legalization bill passed by the House, HB 639, despite its bipartisan support.

Last May, the House rejected marijuana legalization language that was included in a Medicaid expansion bill. The Senate also proposed introducing another bill that month that would have allowed patients and designated caregivers to grow up to three mature plants, three immature plants and 12 plants for personal therapeutic use.

After the Senate rejected reform bills in 2022, the House included language on legalization as an amendment to separate criminal justice legislation, but that amendment was also overturned by the opposite chamber .

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Photo courtesy of Mike Latimer.