New Hampshire Medical Medical Expansion Bills Near Final Passage As Recreational Legalization Also Advances

As New Hampshire lawmakers move toward potentially making the state the 25th in the U.S. to legalize recreational marijuana, separate legislation to significantly expand the state’s existing medical cannabis program is also advancing toward final passage.

House and Senate negotiators on conference committees arrived at deals on language for the measures ahead of a Thursday deadline. One proposal would allow doctors to recommend marijuana for any condition they believe would be improved through cannabis use, and the other would expand the pool of healthcare professionals who can recommend medical marijuana.

Both bills now return to each legislative chamber for up-or-down votes. If they succeed, they would next go to the desk of Gov. Chris Sununu (R).

The compromises come in addition to agreement reached Thursday on legislation to legalize and regulate marijuana for adults, a bargain struck after months of tension between the two houses on how to approach the reform.

On the qualifying conditions bill, HB 1278, members of the conference committee agreed to go with the version of the bill passed by the House in March, recommending that its language be adopted by both chambers.

“The Senate has receded from their amendment and acceded to the House position,” Rep. Erica Layon (R) wrote in a House conference committee report, “which empowers providers to certify adults 21 and older for therapeutic cannabis through 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 qualifying conditions for medical marijuana “any debilitating or terminal medical condition or symptom for which the potential benefits of using therapeutic cannabis would, in the provider’s clinical opinion, likely outweigh the potential health risks for the patient.”

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

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

The proposal would not do away with the enumerated list of qualifying conditions, which Thomas said was a useful way for clinicians who are less familiar with cannabis to navigate the system. “The point of this is that they would be allowed to…refer a patient to the program for any condition that they think would fit and benefit the patient,” she explained.

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The other measure, SB 357, would expand the authority to recommend medical marijuana to any New Hampshire healthcare provider “who is licensed to prescribe drugs to humans and who possesses an active registration from the United States Drug Enforcement Administration [DEA] to prescribe controlled substances.” Those providers would need to be “primarily responsible for the patient’s care related to his or her qualifying medical condition.”

After that bill was passed by 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 the New Hampshire’s medical marijuana program, and it would update an “outdated reference” in the law’s existing section on physician assistants, according to a House conference committee report from Layon.

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

Marijuana possession wouldn’t become legal until 2026, once the state’s licensed market is up and running. That same year, possession of up to two ounces of marijuana would become fully legal. In the meantime, possession of up to one ounce of cannabis would carry a $100 maximum civil fine.

Home cultivation of cannabis for personal use would remain illegal, and the state’s Liquor Commission would have the authority to enforce that provision.

“The House was able to get some concessions from the Senate, which includes edibles in automobiles for passengers, increasing possession from the current law of 3/4 of oz to 1 [ounce],” Rep. John Hunt (R) wrote in the House’s conference committee report, as well as “changing the date for the medical marijuana providers becoming for profit, and an additional ATC member for the oversight commission.”

Sununu has previously said that he would accept legislation based on the Senate-passed version of the bill—as long as House lawmakers make no major adjustments. His office did not immediately respond to a request for comment sent on Thursday.

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

Bicameral lawmakers also convened the state commission tasked with studying legalization and proposing a path forward last year, though the group ultimately failed to arrive at a consensus or propose final legislation.

The Senate defeated a more conventional House-passed legalization bill last year, HB 639, despite its bipartisan support.

Last May, the House defeated marijuana legalization language that was included in a Medicaid expansion bill. The Senate also moved to table another piece of legislation that month that would have allowed patients and designated caregivers to cultivate up to three mature plants, three immature plants and 12 seedlings for personal therapeutic use.

After the Senate rejected the reform bills in 2022, the House included legalization language as an amendment to separate criminal justice-related legislation—but that was also struck down in the opposite chamber.

Bipartisan Lawmakers Demand VA Allow Its Doctors To Recommend Medical Marijuana In Light Of Rescheduling Move

Photo courtesy of Mike Latimer.