Amendment 2: What to Expect
By John Payne
John Payne was the campaign manager for New Approach Missouri and has since co-founded Amendment 2 Consultants and serves on the advisory board of the Missouri Medical Cannabis Trade Association.
Last fall, Missourians voted to legalize medical marijuana by passing Amendment 2 by a margin of nearly two to one and winning nearly 1.6 million votes. It received more votes than newly elected U.S. Senator Josh Hawley (1.2 million), ethics reform (1.4 million), the minimum wage (1.5 million), or even bingo (1.2 million) to become the most popular item on the ballot in Missouri in 2018.
Perhaps most impressive of all, Amendment 2 prevailed over not just one, but two other medical marijuana initiatives on the ballot. No state had ever voted on multiple marijuana measures at the same election, and the conventional wisdom held that this would confuse voters and split the vote, sinking all three proposals. Nevertheless, Amendment 2 soundly defeated both Proposition C and Amendment 3. The fight against Amendment 3 – which was financed by a wealthy Springfield trial attorney who outspent our entire campaign – was particularly fierce, and it ultimately earned fewer than half the votes of Amendment 2. Missourians spoke clearly in the election: They support medical marijuana as an option for patients with debilitating conditions, and they strongly preferred the system proposed by Amendment 2.
We are now working through the implementation stage of the program. The amendment gives the Missouri Department of Health and Senior Services (DHSS) the power to regulate medical marijuana, and, unlike in a number of other states, the department has devoted themselves to following the law faithfully, meeting their deadlines, and enshrining patient access as the primary focus of the program.
The next big deadline approaching is June 4, when DHSS must release a final set of rules and regulations, as well as application forms for patient identification cards and businesses that hope to cultivate, extract, and dispense medical marijuana. 30 days later on July 4, the department must begin accepting applications for patient identification cards. On August 3, they will accept industry applications, and they have 150 days to score and rank those applications according to merit-based criteria defined in the amendment. We can expect the first licenses to commercially grow and sell medical marijuana in Missouri to be approved by December 31 of this year.
The number of patients who will participate in the medical marijuana program has been the subject of a great deal of speculation recently. A report created by several economists at the University of Missouri argues that, by 2022, only 26,000 Missourians will hold patient identification cards – or less than half a percent of the state’s population. They arrive at this figure by examining the data of all the states with legal medical marijuana as of 2015 and assuming that Missouri will land in the middle of the distribution.
That is an understandable way to make this projection, but there is good reason to think that it is not the best method. Amendment 2 creates a broad set of qualifying conditions that gives doctors discretion over which patients they certify for the program. Many states – such as Minnesota, New Jersey, Connecticut, Delaware, and our neighbor Illinois – only allow medical marijuana for a much more restrictive set of conditions. Not surprisingly, very few patients are able to access medical marijuana in those states.
When looking at states that have both a broad set of qualifying conditions and reliable data for patient counts, we see that mature medical marijuana programs generally enroll between two and three percent of the state’s population. In Missouri, that would mean between 120,000 and 180,000 patients after three years of operation.
Oklahoma’s recent experience is instructive here. The Sooner State passed a medical marijuana law with broad qualifying conditions last summer, and nearly 90,000 patients have already been approved for the program. In under a year, 2.3 percent of Oklahoma’s population has registered as a medical marijuana patient, a number that is only expected to grow.
Only time will tell exactly how Missouri’s experience with medical marijuana will play out, but I am extremely encouraged by the support we have seen from the general public, elected officials, and regulators. We are bound to experience some challenges along the way, but I believe we have the sound framework and the committed and skilled people to make Missouri’s program the best in the country.