Despite program expansions, cost remains a key barrier to access
The recent midterm elections brought some big wins for cannabis advocacy. In addition to Michigan adopting full legalization, both Missouri and Utah passed measures that provide access to medical cannabis. Many politicians who ran legalization platforms were elected, indicating that changes will continue sweeping the nation.
Just recently, dispensaries in Massachusetts finally opened for recreational purchases in a historic first for the East Coast. All eyes will be on the state as others in the region look to develop their models of cannabis policy and regulation. In fact, New York and New Jersey may be next to legalize recreational cannabis as the pendulum swings across the country.
While those living in these states have had access to medical cannabis, New Jersey has recently expanded its program to include additional conditions, such as migraines and chronic pain. The New York Health Department also issued recent guidance that recommends expanding New York’s program as well, in an effort to quell the opioid crisis and allow patients to use cannabis instead for pain management.
While making medical cannabis more available for prospective patients is critical in places where recreational cannabis remains illegal, patients may still face barriers to access due to cost. While each state’s program is handled differently, people first pay for a consultation with their physician to get certified. Then, they pay for their annual medical card, and, of course, for the products themselves. Depending on the condition, products alone may cost hundreds of dollars a month, with none of the cost covered by insurance.
Recent legislation introduced in New York looks to change that. Assemblyman Richard Gottfried and colleagues proposed a bill that would require public health care plans, including Medicaid, to cover medical cannabis to lower out-of-pocket costs. While this is great news, an obvious question remains – why haven’t insurance companies been covering medical cannab is costs if states have already approved these programs?
The Controlled Substances Act of 1970 categorized cannabis as a Schedule I drug – a compound with no currently accepted medical use and a high potential for abuse. Therefore, the FDA needs approve cannabis as an effective medicine before insurance companies will cover incurred costs.
Approval of this legislation would be a huge win for patients in New York and possibly send a signal to other states with similar programs. But, the issue of access does not fall on cost alone. One study discussed the finding that white Americans are the primary users of medical cannabis, as people from minority demographics may not seek out treatment due to stigma and fear of legal prosecution.  Additionally, socioeconomic status and physician attitudes can greatly influence both initiation of consultation and access to medicinal products.
As additional policy changes regarding medical cannabis use are implemented across states, legislators must also consider all aspects of access, including treatment and care, as part of their updated programs.
- Celina,V.I.,Asaolu, I.O., Ehiri, J.E., et al., “Structural Barriers in Access to Medical Marijuana in the USA—A Systematic Review Protocol”, Systematic Reviews, 2017, Volume 6, pg. 1-8.
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