New York Senate Approves Bill To Mandate Medical Marijuana Health Insurance Coverage

The New York Senate approved a bill on Wednesday that would require public health insurance programs to cover medical marijuana expenses and clarify that private insurers are allowed to do the same.

The legislation, sponsored by Diane Savino (D), moved through two committees before passing the Senate by a vote of 53-10, and it’s now been transmitted to the Assembly, where it awaits action in the Ways & Means Committee.

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 so 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.

“For thousands of patients, medical marijuana is a safer and more effective medication than other drugs, especially opioids,” a justification memo attached to the bill says. “While it can be prohibitively expensive for many patients, especially in the absence of insurance coverage, it may often be less expensive than what their insurance coverage pays for other medications.”

Responding to concerns from fellow lawmakers on the floor ahead of the vote about the potential costs of the legislation, Savino said that “it is time for New York State to lead the way on this issue.”

“Some state is going to have to force this issue,” she said. “I believe that our state is the one that should lead the way on this.”

If the bill is enacted, public health insurance programs that would be subject to the proposed policy change include Medicaid, Child Health Plus, Elderly Pharmaceutical Insurance Coverage (EPIC), Essential Plan programs and workers compensation.

“Cost is the primary barrier to patient access in New York’s medical marijuana program. Medicaid, other public health plans, and commercial health insurance plans do not cover medical marijuana, forcing patients to pay out of pocket,” the justification memo continues. “Some patients begin treatment only to stop due to inability to pay, while others turn to the black market. Efforts by registered organizations to offer discounts have helped, but are inadequate for many low-income patients.”

While there “would presumably not be federal matching funds until the federal government changes its policies” for programs like Medicaid and Child Health Plus, the memo says that “New York’s Medicaid and Child Health Plus programs have always covered people and services for which we do not receive federal match.”

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Additionally, the legislation would allow the state health commissioner to certify medical marijuana dispensaries as Medicaid providers, as long as they only sell medical cannabis and not any other drugs.

A fiscal impact statement notes that there would be “substantial” cost savings if the bill is enacted “to the extent medical marijuana displaces other prescription drugs.” And several studies have found that many people have used cannabis as a substitute for a variety of prescription medications such as opioid-based painkillers.

If passed in the Assembly and signed by the governor, the bill would take effect starting the following April. But for 2022, the normal legislative session is scheduled to end on Thursday, meaning it will likely need to be reintroduced unless it’s brought up in a special session.

Similar legislation was filed in the Assembly in 2018, but it did not advance out of committee.

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

With respect to workers compensation, there have been various court cases where employees have sought relief from their employers to cover medical cannabis costs for injuries they incurred on-site. Two Minnesota cases on the issue reached the U.S. Supreme Court, but the Justice Department asked justices to reject the case last month. Part of the department’s reasoning, however, was that it felt the matter would be better addressed by the executive or legislative branches.

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