“True stability requires comprehensive federal legislation that creates a national medical cannabis framework to recognize cannabis-based therapies as part of modern healthcare.”
By Steph Sherer, Americans for Safe Access
Last week, the House Appropriations Committee declared victory, announcing:
“More than 95 percent of the federal government is funded through full-year FY2026 appropriations—delivering stability, certainty, and results for the American people.”
But for millions of medical cannabis patients, that claim rings hollow.
Instead of delivering stability, the Fiscal Year 2026 budget reinforces a troubling reality: Congress continues to manage medical cannabis through temporary fixes and political compromises—rather than building a healthcare system patients can rely on.
Widespread misinformation about the true impact of President Donald Trump’s December 2025 executive order is compounding uncertainty for patients. While the order does emphasize research and coordination, it does not resolve core access barriers, create new patient protections or replace the need for congressional action. So, while a significant development, it is not necessarily the breakthrough it has been portrayed as.
As a result, uncertainty is growing across the patient community. Those who rely on hemp-derived medicines, veterans dependent on Department of Veterans Affairs (VA) healthcare and people living in newly authorized or underdeveloped state programs are particularly vulnerable. For many, the future of their care feels more precarious today than it did a year ago.
A Letdown To End The Shutdown
In November 2025, Congress passed a massive stopgap spending bill to end a federal shutdown. It combined several budget measures into H.R. 5371, The Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act, 2026, and pushed the rest into a short-term funding extension.
Congress Delivered 2 Major Blows in November with the Passage of H.R. 5371
Under the Agriculture portion of the spending bill, Congress permanently redefined hemp and hemp-derived cannabinoid products. These changes were long overdue and designed to close what lawmakers called the “hemp loophole,” which had allowed intoxicating products to spread nationwide with little oversight. However, these provisions, set to take effect in November, will also remove most full-spectrum products from lawful hemp commerce.
From a regulatory standpoint, the new language brings clarity. From a patient standpoint, it will bring disruption.
Millions of Americans rely on full-spectrum hemp products to manage seizures, cancer symptoms, chronic pain, PTSD and neurological disorders—often because their states lack functional medical cannabis programs. Unless Congress intervenes, millions of patients will lose one of their few affordable treatment options. For people already marginalized by the healthcare system, this is not a technical regulatory adjustment. It is a looming healthcare crisis.
In response, Americans for Safe Access recently released a policy briefing, Protecting Patient Access: A Compassionate Response to Changing Federal Hemp Laws, calling on states to create transitional pathways for patients. But state action can only go so far in the absence of federal leadership.
Veterans Left Behind—Again
The second blow came in the VA portion of the legislation.
For more than fifteen years, advocates have sought to allow Veterans Health Administration providers to recommend medical cannabis and assist veterans with state program enrollment. Language to do so appeared in both House and Senate bills but did not make it into the final legislation signed into law.
Under current VA policy, providers remain prohibited from recommending, referring, or assisting veterans with medical cannabis—even in states where it is legal. Veterans coping with chronic pain, traumatic brain injury, and PTSD are left to navigate fragmented systems without clinical support.
Once again, those who served our country are denied access to care that could improve their quality of life.
Another Year Of Protections For Some
To be clear, the FY2026 budget was not a total loss for patients.
Medical cannabis protections were preserved in the Commerce, Justice, Science (CJS) and other related agencies appropriations. Advocates successfully removed provisions that would have blocked rescheduling and another that would have reopened the door to federal interference in state programs.
These protections remain temporary and require annual renewal. Since 2014, the Medical Marijuana CJS Amendment has protected state medical cannabis programs, patients and healthcare providers from federal prosecution, arrest, asset forfeiture and harassment. The provision has received bipartisan support for more than a decade and was meant to serve as a critical safeguard while Congress works toward comprehensive medical cannabis legislation.
Unfortunately, Nebraska was excluded from the longstanding medical cannabis amendment that bars federal agencies from interfering with state programs—despite voters decisively approving medical cannabis in 2024. Advocates had hoped that Nebraska’s exclusion was a technical oversight, as this marks the first time since the amendment’s initial passage in 2014 that a newly authorized medical cannabis state was not added.
More concerning is that Sen Deb Fischer (R-NE), a member of the Senate Appropriations Committee, did not offer an amendment to correct this omission. Nebraska’s struggle for safe access has been particularly contentious. In March 2025, Sen. Pete Ricketts (R-NE), the former governor of Nebraska, weighed in on the state legislature’s implementation efforts in an op-ed in the Omaha World-Herald, co-authored with the state’s attorney general, warning lawmakers not to allow the program to move forward—an intervention widely viewed as an overreach of his federal position.
Meanwhile, Congress declined to fund meaningful medical cannabis oversight at the Department of Health and Human Services (HHS). Despite Trump’s executive order emphasizing research and coordination, no dedicated resources were provided. Implementation is left to existing agency budgets and shifting priorities.
The order directs HHS to explore real-world evidence and standards of care. But without funding or statutory authority, these efforts will remain limited.
Regulatory Changes Can’t Fix A Broken System
Uncertainty Extends Beyond Appropriations
In January, the Centers for Medicare & Medicaid Services closed public comments on proposed rules that would allow non-cannabinoid hemp products and certain cannabis products legal under state or federal law to be reimbursed under the Special Supplemental Benefits for the Chronically Ill (SSBCI) program.
While a modest step forward, it offers little practical relief for many patients. Individuals in hospice, assisted living and long-term care facilities are still often prohibited from accessing these therapies until federal law changes—leaving some of the nation’s most vulnerable patients caught between policy reform and legal reality.
This week, the Food and Drug Administration faced a deadline (February 10) under the new hemp law to publish a list of all cannabinoids produced by the plant, clarify THC-related compounds, and define container limits. But this technical exercise will not prevent the loss of access. The agency is implementing a statute. It cannot rewrite it
Meanwhile, Trump’s executive order also directed the Department of Justice to revive the stalled cannabis rescheduling process. But rescheduling alone will not create a medical program, protect patients or integrate cannabis into healthcare.
Without comprehensive legislation, these regulatory efforts—however well-intentioned—amount to administrative adjustments layered onto a fundamentally broken system.
Stability Requires Legislation
For more than a decade, Congress has relied on short-term protections, budget riders and partial reforms to manage medical cannabis. That approach has reached its limits.
Patients cannot build treatment plans around temporary funding provisions. Healthcare systems cannot integrate therapies governed by annual political negotiations. Veterans cannot depend on executive discretion. Families cannot plan their care in the face of regulatory uncertainty.
True stability requires comprehensive federal legislation that creates a national medical cannabis framework to recognize cannabis-based therapies as part of modern healthcare, empowering HHS to oversee safety, standards,and integration.
Bottom line, patients need protection regardless of where they live, what system they rely on or which political party controls Congress. Patients need a system that treats their medicine as a lifeline, not an afterthought.
Steph Sherer is the founder and executive director of Americans for Safe Access. The organization has published a congressional briefing on medical cannabis issues.
Marijuana Moment is made possible with support from readers. If you rely on our cannabis advocacy journalism to stay informed, please consider a monthly Patreon pledge.
