By Baylor Spears, Wisconsin Examiner
The Wisconsin Examiner reported that the policy experts who reviewed the Wisconsin Assembly Republicans’ proposal for medical marijuana legalization expressed concern about the cost, accessibility, and possible conflicts with the federal governments.
Assembly Republicans’ proposal would create an Office of Medical Cannabis Regulation within the Department of Health Services. The office would keep a list of patients and caregivers that could buy medical cannabis products at one of five state run dispensaries. Patients with certain medical conditions would only be allowed to access the products. These would include edibles, pills, oils and other forms of cannabis, but not anything that could be smoked.
Senate Republicans have criticized the bill, citing concerns over state-run dispensaries as well as an expansion of government. Assembly Speaker Robin Vos, R-Rochester, has stated that the Assembly will continue to move forward with this bill.
Vos, during a recent press conference, said: “I’m not really interested in amending or changing a bill because of what someone thinks…could occur.” Vos said, “I have tried this before, but usually without success. That’s why I want to pass a bill in the Assembly to demonstrate that we are behind the concept, and then let Senate do what it wants.”
Vos stated that the Assembly is likely to vote on the bill by February.
Minnesota’s restrictive program
Vos, who spoke ahead of ‘s unveiling of its medical cannabis proposal said it was “probably the most restrictive version of the entire country.” He also said that it was heavily influenced by Minnesota’s medical cannabis program.
In interviews with the Wisconsin Examiner, Leili Fatehi and Maren Schröeder, experts in Minnesota cannabis policy, told the Wisconsin Examiner that certain policies included in Wisconsin’s proposal would increase costs and make access to the drug more difficult.
Fatehi said to the Wisconsin Examiner that Minnesota had one of most restrictive and costly medical cannabis programs. She explained that the program passed under the former Minnesota Governor Mark Dayton in 2014. Dayton was a Democrat and not a huge supporter of marijuana in general. This was one reason why the program began with more restrictions.
Minnesota’s medical cannabis law was amended multiple times over the years to modify some features and loosen restrictions. In spring 2023 , the state will legalize marijuana for recreational purposes.
Wisconsin’s program is similar to Minnesota’s, in that patients are required to confirm their medical condition by consulting a prescriber before applying to be included on the state patient registry. The Wisconsin bill limits access to certain medical conditions, including cancer, epilepsy or HIV/AIDS, glaucoma and post-traumatic anxiety disorder (PTSD). Other conditions include multiple sclerosis, inflammatory bowel diseases, severe chronic pain and severe muscle spasms. The co-sponsorship memorandum states that future legislation could add additional conditions.
Fatehi stated that a patient database is important for a number of reasons. He also said that Minnesota advocates of adult recreational use still believe it’s important to have an effective medical program. These reasons include information about medical users to ensure patients receive the best treatment possible and that manufacturers produce enough product to meet demand.
Fatehi stated that “having a program to ensure that the additional needs of patients by virtue of their illness…is very, very important.” If you create a system which is so restrictive or structured that the final product becomes very expensive or hard to obtain, you leave patients with no choice but to buy their cannabis on the illegal market, and this puts a vulnerable group at risk.
The first state-run dispensaries in the nation
The proposal has been the biggest concern for the Senate. This provision is the most controversial in the Senate. Senate Majority leader Devin LeMahieu called it a nonstarter for much of his group .
The Assembly Republicans stated in their co-sponsorship letter that they would establish state-run medical marijuana dispensaries to create a program which would “work” for Wisconsin. They claimed they had conducted an “extensive study” of the medical cannabis programs of 38 states and that they discarded “policies which have led widespread abuse of medical programs.”
Rosanna Smart is an economist at the RAND Drug Policy Research Center. She said that state-run dispensaries could potentially conflict with federal laws, which may be the reason why other states have not adopted this approach.
Marijuana is illegal at the federal level, despite its legalization in some states. The federal Controlled Substances Act classifies marijuana as a Schedule I substance, which is a drug that has no accepted medical uses and high abuse potential.
Smart explained that “given cannabis’s federal status, it is possible that the state could be in danger if the federal government decides to crackdown on cannabis,” Smart said. “That’s why historically, states have chosen not to do the same thing as Wisconsin.”
Smart stated that there have been concerns in the past about the state licensing of dispensaries because of the federal status. She stated that New Mexico’s medical marijuana program, which was passed in 2007, did not license until 2009. This is because officials believed the federal government to have a “non enforcement policy.”
Smart explained that many states now license dispensaries. “There’s been a continued renewal of the federal non-enforcement policies toward medical cannabis programs which are operating within reasonable bounds. But if there is a change of administration, then it will be uncertain.”
Smart stated that Wisconsin could theoretically have more control of prices and monitor products closely, but state-run dispensaries may also impact the cost of medical marijuana products for patients.
Smart stated that because Republicans have declared the state won’t be seeking tax revenue through the program, the price of medical marijuana for patients should be low. Smart said that the state of Wisconsin, which is a public entity, may incur more costs to run a dispensary than a private company. These costs, in theory will be passed onto the patients.”
Schroeder, of High Level Strategies, said that the Minnesota state law currently permits 15 medical cannabis dispensaries.
Schroeder stated that the proposed five-person limit in Wisconsin will create barriers in rural areas. “Wisconsin, a smaller geographically state, had more than triple that number. And even when we first started, we began with eight. That was hugely problematic.”
Smart stated that five dispensaries is a small number of medical programs. She noted that Iowa, which has a smaller population, allows five dispensaries to be included in its medical program.
Growing and processing in the program
The state of Wisconsin will run the dispensaries while the private sector will be responsible for growing and processing.
Department of Agriculture, Trade and Consumer Protection would be responsible for regulating and overseeing the growing of marijuana, as well as testing and processing of the products. DATCP would license cannabis growers and processing companies.
Smart stated that the lack of experience the state has in the cannabis industry is probably why the authors chose to have Wisconsin “do private contracting with growers and processors who can certainly do this more efficiently than state government could.”
Schroeder stated that by separating cultivation and processing from retail, the state could be protected from vertical integration – where a single company controls the entire process. She noted that making both cultivation and processing private would allow businesses to charge whatever they like for the products.
Schroeder stated that Minnesota tried to control this by stating that medical manufacturers “cannot make huge profits”. Despite this, she claimed, Minnesota’s medical cannabis manufacturers increased their costs, which led to an increase in prices, particularly once they became multi-state operators.
The Wisconsin bill may provide protection against multi-state operators. For a license as a processor or grower, 80 percent of the company’s officers or directors must be Wisconsin residents.
Smart added that a provision which would limit the licensing to a single processor until the program reached a certain size, could also increase the costs.
According to the bill, DATCP will only be able license and contract one processor until at least 50,000 patients are included in the registry. “After that, DATCP can license and contract as many processors necessary to process an ample supply of medical marijuana products to meet demand for patients in this State.”
Smart stated that having only one processor within a state could lead to a monopoly. She said that questions like how prices would set and how government would negotiate price could be worked out during the regulation process. She said that if the processor took a lot of rent, they would be making a lot of profit.
Smart suggests that another alternative would be to require the processor to be non-profit. Smart added that “having one processor could be a vulnerability for your supply chain and creates monopoly power in the processing area.”
Smart questioned also how legislators came up with the threshold of 50,000 before authorizing multiple processors. This is a much higher number than people registered for other medical programs in other states.
Minnesota currently only has 44,000 registered patients and Iowa has approximately 18,000 patients.
Lacking raw flower
Experts in policy said that restrictions on the types of products allowed could increase costs for consumers. Wisconsin’s program allows for concentrated products, oils, tinctures and edibles. It also permits topical forms such as gels, creams or patches.
Raw flower was banned when Minnesota’s medical program began. Schroeder stated that this increased the price of products available to patients and prevented some from accessing their preferred product.
Schroeder stated that raw cannabis is cheaper than processed cannabis, and many patients prefer this method.
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Schroeder says that some patients prefer inhalable products because they are quicker than edibles. This can be important for patients who suffer from pain or spasms. Inhalable cannabis oil was the most common form of inhalable cannabis before raw cannabis became legal. Vaporized oil is usually more expensive. She said that it is more potent, which some patients do not want.
Schroeder explained: “When you talk about vaporized oils, you are talking about an oil that is more concentrated and has a higher percentage THC than your flower which will have a THC average of 20 percent,” she said. Raw flower cannabis has a lower concentration and is preferred by patients who find vaporized oil to be too strong.
After several years of patient and other advocacy, these products were only added to the program by 2021.
Schroeder stated that Minnesota saw an increase in patients after smokable products were made available. She also said the prices weren’t too high, but they were still better. She said that the products were more accessible and affordable for patients.
Schroeder suggested that legislators discussing a possible program speak to patients and legislators from other states including Minnesota, Michigan, and Illinois to gain a perspective on the matter.
Schroeder stated, “When patients look at this bill I am looking at the chance to have safe and secure access.” They need to understand that under a restricted model we will have access to the drugs, but that access is going to be costly and that they are going to quickly discover that this access is not actually access. This is what we discovered.”
She said, “I always advocated saying, ‘Well at least something is much better than nothing. We can build on it.'” But Wisconsin will be building with this proposal for a very long time.
The story was originally published by Wisconsin Examiner.
The post Wisconsin Republican Medical Marijuana Plans Raises Concerns about Cost, Patient Accessibility, And Federal Conflicts, Advocates Say first appeared on Marijuana Moment.
