The Hawaii Senate passed legislation last week that could significantly expand access to medical marijuana in the state. With a vote of 24-1 on April 8th, Senate members endorsed HB 302, a bill aiming to grant healthcare providers the ability to recommend medical marijuana for any condition they deem appropriate. However, just two days later, the House disagreed with the Senate’s amendments that it passed with, leaving the future of HB 302 uncertain.
What is HB 302?
HB 302 seeks to redefine the landscape of medical cannabis in Hawaii. The bill proposes changing the definition of “debilitating medical condition,” allowing physicians and advanced practice registered nurses (APRNs) to use their professional judgment to recommend cannabis for any condition—not just those currently listed in state law.
Currently, Hawaii limits medical cannabis use to a set of specific qualifying conditions, such as cancer, severe pain, epilepsy, and multiple sclerosis. HB 302 seeks to broaden the eligibility criteria, aiming to reduce barriers and make medical cannabis more accessible to those in need.
The bill introduces several ideas to improve the medical marijuana program. First, it allows telehealth consultations for establishing patient-provider relationships, eliminating the need for an in-person meeting before access. This change is expected to make accessing medical marijuana easier for patients.
Additionally, the bill proposes easing licensing regulations. It would permit dispensaries to purchase products from one another and introduce cultivation licenses, creating more flexibility within the supply chain. At the same time, the bill aims to crack down on illegal activities by implementing stricter penalties for unlicensed dispensaries and illicit cannabis advertisements.
Why HB 302 Matters for Medical Marijuana in Hawaii
Hawaii has long been a player in cannabis reform. It became the first U.S. state to legalize medical marijuana through legislative action in 2000. Despite its initial progress, Hawaii’s medical cannabis industry has encountered hurdles over the years. Patient registration peaked in 2021 with 35,444 cardholders but dropped by 15% to 30,035 cardholders by late 2024, according to the bill.
The decline in registered patients points to the fact that many individuals are turning to the illicit market due to high costs, regulatory delays, and limited access to dispensaries. HB 302 aims to tackle these challenges directly by simplifying the cannabis certification process to encourage more patients to register.
The bill also focuses on expanding cultivation and dispensary operations to strengthen the legal supply chain. Additionally, it seeks to promote safer and more regulated access to cannabis for patients.
These proposed changes have the potential to reboot Hawaii’s medical cannabis program, especially since recent legislative efforts to legalize recreational cannabis in the state failed, HB 302 could bridge the gap between patient needs and legislative efforts.
Arguments For and Against HB 302
Supporters argue that HB 302 offers a compassionate approach to healthcare by trusting medical providers to determine the best course of treatment for their patients. They emphasize that healthcare professionals already have the authority to prescribe potentially dangerous pharmaceuticals off-label, so similar trust should extend to medical marijuana.
Karen O’Keefe, the director of state policies at the Marijuana Policy Project, stated in an article by Marijuana Moment, “Doctors are allowed to prescribe far more dangerous drugs off-label than marijuana. They should be similarly entrusted to advise their patients on whether they could benefit from cannabis.”
The bill also has the potential to address disparities in healthcare access. Many patients, particularly in rural areas, struggle to obtain medical marijuana recommendations due to a lack of providers. Allowing telehealth consultations could significantly help this issue.
However, the Hawaii Department of Health (DOH) has reservations about HB 302. The department is concerned about what they say is a lack of scientific evidence supporting marijuana use for certain conditions and the potential risks posed by adverse drug interactions. Additionally, the DOH has opposed extending certification authority to non-primary care providers.
Critics also worry about market oversaturation. The Hawai‘i Cannabis Industry Association (HICIA) testified against the addition of new cultivation licenses, noting that dispensaries already operate below capacity and that increasing supply could lead to more products entering the illicit market.
Legislative Hurdles and Next Steps For Expanded Medical Marijuana in Hawaii
While the Senate’s overwhelming support signals strong momentum for HB 302, the House of Representatives’ disagreement on the bill’s amendments poses a significant roadblock. Lawmakers must now collaborate to reconcile their differences and finalize the bill’s language.
If the House ultimately agrees with the Senate’s amendments, the bill will land on Governor Josh Green’s desk. Gov. Green has expressed support for expanding medical marijuana access, describing the bill as a potential “happy medium” between prohibition and full legalization. During his 2023 campaign, he stated, “This would make … marijuana very available for those who choose it in their lives and would still keep kids safe, which has been everyone’s priority.”
However, the governor’s approval is dependent on the bill overcoming its current legislative impasse.
HB 302 represents a significant step forward for medical marijuana reform, but its success relies heavily on collaboration between the Senate and the House. Should the bill pass, it could make history by putting Hawaii as a frontrunner for medical marijuana access, giving physicians greater say in patient care.
