Last week, the New York Senate passed legislation requiring public health insurance programs to cover medical marijuana expenses and clarifying that private insurers may do the same.
The legislation, sponsored by Diane Savino (D), passed the Senate by a vote of 53-10, and it has now been transmitted to the Assembly, where it awaits action in the Ways and Means Committee.
SB S8837 amends state public health and social services statutes to address one of the most significant barriers to patient access to medical cannabis: the medication's out-of-pocket cost.
It would accomplish this by classifying medical marijuana as a "prescription drug," "covered drug," or "health care service" under the relevant codes, requiring public health insurance providers, such as Medicaid and workers compensation, to provide coverage. Cannabis coverage, on the other hand, would be optional for private, commercial insurers.
According to a justification memo attached to the bill, "for thousands of patients, medical marijuana is a safer and more effective medication than other drugs, particularly opioids." "While it can be prohibitively expensive for many patients, particularly those without insurance coverage, it is frequently less expensive than what their insurance coverage pays for other medications."
Responding to concerns raised by fellow lawmakers on the floor about the potential costs of the legislation before the vote, Savino stated that "it is time for New York State to lead the way on this issue."
"Some state will have to force this issue," she predicted. "I believe that our state should set the example in this regard."
If the bill is passed, public health insurance programs such as Medicaid, Child Health Plus, Elderly Pharmaceutical Insurance Coverage (EPIC), Essential Plan programs, and workers compensation would be affected by the proposed policy change.
"In New York's medical marijuana program, the primary barrier to patient access is cost." "Medicaid, other public health plans, and commercial health insurance plans do not cover medical marijuana, forcing patients to pay out of pocket," according to the justification memo. "Some patients begin treatment only to discontinue it due to a lack of funds, while others resort to the black market." Discounts offered by registered organizations have helped, but are insufficient for many low-income patients."
While the memo states that "there would presumably not be federal matching funds until the federal government changes its policies" for programs such as Medicaid and Child Health Plus, it also states that "New York's Medicaid and Child Health Plus programs have always covered people and services for which we do not receive federal match."
Furthermore, the bill would allow the state health commissioner to certify medical marijuana dispensaries as Medicaid providers if they only sell medical cannabis and no other drugs.
According to a fiscal impact statement, if the bill is passed, there will be "substantial" cost savings "to the extent medical marijuana displaces other prescription drugs." Several studies have also discovered that many people have used cannabis as a substitute for a variety of prescription medications, including opioid-based painkillers.
If passed by the Assembly and signed by the governor, the bill will go into effect in April of the following year. However, because the regular legislative session ends on Thursday in 2022, it will almost certainly need to be reintroduced unless it is brought up in a special session.
Similar legislation was introduced in the Assembly in 2018, but it never made it out of committee.
Outside of New York, the largest marijuana company in New Mexico made a push earlier this year to have insurers cover medical cannabis expenses, which it claimed was required by law, but that effort has yet to result in a policy change.
In terms of workers' compensation, there have been several court cases where employees have sought relief from their employers to cover medical cannabis costs for on-the-job injuries. Two Minnesota cases on the issue reached the United States Supreme Court, but the Justice Department asked the justices last month to dismiss the case. The department's reasoning included the belief that the issue would be better addressed by the executive or legislative branches.
