Overview of MMJ Programs in the United States

Kim DelMonico, OCBMAGONLINE Contributing Writer

While cannabis is still illegal under United States federal law, there are now 46 states that have some form of medical cannabis laws.

A total of 31 states, the District of Columbia, Guam and Puerto Rico have comprehensive public medical marijuana and cannabis programs. According to the National Conference of State Legislatures, a comprehensive medical marijuana program must:

(1) Offer protection from criminal penalties for using marijuana for a medical purpose.

(2) Allow access to marijuana through home cultivation, dispensaries, or some other system.

(3) Allow a variety of strains, including more than “low THC.

(4) Allow either smoking or vaporization of some kind of marijuana products.

Fifteen other states allow use of “low THC, high cannabidiol (CBD)” products for medical reasons in limited situations or as a legal defense.
Have these programs been a success? Let’s take a look at some of the United States’ MMJ programs and their results.


In 1996, California voters passed Proposition 215 or the Medical Use of Marijuana Initiative, making it the first state to allow for the medical use of marijuana. The ballot summary said:

Exempts patients and defined caregivers who possess or cultivate marijuana for medical treatment recommended by a physician from criminal laws which otherwise prohibit possession or cultivation of marijuana.
Provides physicians who recommend use of marijuana for medical treatment shall not be punished or denied any right or privilege.
Declares that measure not be construed to supersede prohibitions of conduct endangering others or to condone diversion of marijuana for non-medical purposes.

Proposition 215 passed by 55.58%, with 5,382,915 Californians voting “yes” and 4,301,960 voting “no.”

On January 2, 2018, California also legalized recreational marijuana with the passage of Proposition 64. It also imposed a 15% statewide tax on all recreational and medical cannabis products, in addition to local taxes in fees. Since legalizing cannabis, California has tallied an impressive $2.75 billion in cannabis sales.

Cannabis has also been lucrative for California’s local governments. In the first two months of 2018, San Jose made nearly $2.2 million in cannabis revenue. Oakland made $2.86 million in the first quarter of 2018. The small city of Perris, in Riverside County, made $41,124 in taxes from marijuana businesses in the first two months of the year.

However, California law requires cities and counties to get voter approval before they add any local cannabis tax. It can takes months and a lot of money to get measures on the ballot, so some local jurisdictions have opted to let businesses open before taxes are in place, so they can give their local operators a competitive edge. Other cities have done the opposite, instituting taxes, but not yet allowing any cannabis businesses within their borders.

Most of California’s communities tax companies based on a percentage of their sales receipts, with taxes ranging from 2 to 20 percent. Often, different segments of the industry are taxed at different rates. For example, in Los Angeles, tax rates are set at 10 percent for recreational sales, 2 percent for cultivation, and 1 percent for testing.

Other jurisdictions tax the industry as a dollar amount per square foot. This method is typically used for marijuana cultivators. These rates range from $1 per foot to $25 per foot. Some of these jurisdictions charge different amounts to indoor and outdoor growers. For example, in Lake County, outdoor cultivators are charged $1 per square foot while indoor cultivators are charged $3 per square foot.

There are other communities that tax businesses at a flat rate. In Kings County, cannabis businesses are charged a flat annual tax of $30,000.

Once all of these taxes are factored in, cannabis consumers in California are paying as much as 40 percent tax on every legal transaction. State legislators are aware of this and are looking for ways to help the emerging legal cannabis industry compete with the black market.

California Assemblymen Tom Lackey, R-Palmdale, and Rob Bonta, D-Oakland, have authored a bill that proposed to cut the marijuana sales tax rate from 15 percent to 11 percent and suspend all cultivation taxes until June 2021. Lackey explained why he wrote the bill, “We need to give legal businesses some temporary tax relief so they do not continue to be undercut by the black market.”

This proposed bill could have a huge effect on how much revenue California will see from the legal marijuana industry over the next three years. Under the current tax rates, the Legislative Analyst’s Office predicted that California would receive $1 billion per year in revenue from the marijuana excise tax.

Lackey’s office pointed out that the state of Washington saw an increase in cannabis-related tax revenue after the state cut its tax rate in 2015. The increase in revenue has been attributed to helping businesses move more customers to the legal side of the cannabis market.

California legal cannabis industry has not been without problems. One interesting problem that has developed is that they do not have anywhere to put their cash. Because cannabis is still illegal at the federal level, banks that are FDIC insured are unable to legally accept deposits from cannabis sellers.

Despite California’s issues working out the kinks with legalizing cannabis, it has been an overwhelming success for the state. A report from BDS Analytics has estimated that California cannabis sales will hit $3.7 billion by the end of 2018 and will increase to $5.1 billion in 2019.


In Washington, cannabis is legal for adult recreational use, but there are still medical marijuana laws intended to cater to patients who require marijuana for their medical needs. The primary goals of Washington’s medical marijuana laws are: to clarify what is meant by the medical use of marijuana; ensure patients have higher quality products to meet their medical needs; allow for state sales and use tax breaks for medical marijuana patients who are entered into the authorization database; and provide protection from arrest and prosecution for patients who are entered into the authorization database.

Benefits to registering as a medical marijuana patient in Washington include: may purchase 3 times the recreational limits; may possess 6-15 plants; may purchase high-THC compliant products; sales tax exempt purchases from medically-endorsed stores; arrest protection; may participate in a cooperative; may purchase immature plants, clones, and seeds from a state licensed provider. Washington medical marijuana laws are codified at Chapter 69.51A RCW.

In Washington, legal cannabis sales total $1 billion. For the period of 2017-2019, Washington projected $730 million in tax revenues from legalized marijuana. The state allocated 60 percent of that revenue to go toward public health programs, including Medicaid, substance abuse prevention efforts and community health centers. The Liquor and Cannabis Board, which regulates the state’s legal marijuana market, will receive $17 million. Another $30 million will be shared with local governments that allow marijuana sales within their limits. The remaining money, about $211 million, will go into the state’s general fund.

The money allocation follows the plan that was set by Initiative 502, which Washington voters approved in 2012 to legalize recreational marijuana use for adults 21 and over.


In Arizona, medical cannabis sales have brought in $406.7 million in revenue. The Arizona Medical Marijuana Act (AMMA) was approved in 2010 by 50.13% of the voters. This was the third statewide medical cannabis ballot initiative to be approved in Arizona. In 1996, voters passed an initiative allowing doctors to prescribe medical cannabis, but the initiative was rejected by the state legislature. In 1998, Arizona voters again approved a measure allowing doctors to prescribe marijuana, but because the U.S. Food and Drug Administration must approve medicines to be “prescribed,” the measure never took effect.

The AMMA allows patients who have an Arizona registry ID card to use cannabis for medical purposes. Patients are also permitted to grow cannabis and appoint a designated caregiver for assistance. If patients and caregivers live at least 25 miles from a registered dispensary, they may request permission to cultivate their own medicine.

Since the passage of the AMMA, the legislature has passed several laws that restrict the rights of patients. In 2011, HB 2541 allowed an employer to fire a patient for workplace impairment solely on the word of a “reliable” colleague or a positive drug test and HB 2585 added marijuana patient data to the prescription drug monitoring program. In 2012, HB 2349 prohibited medical cannabis at all schools, vocational schools, and college campuses. In 2015, HB 2346 specified that AMMA does not require workers’ compensation benefits to include reimbursement for medical cannabis.


In Connecticut, medical cannabis sales total $50 million.  The state decided to legalize cannabis for medicinal purposes in 2012.  The state has also taken steps towards decriminalizing marijuana.  In 2011,  a new law stated that being caught will possession of less than 0.5 ounces of marijuana was only punishable by a $150 fine.

To qualify for a medical marijuana card in Connecticut, a patient must receive certification from an active practicing physician who is licensed in the state and register with the Department of Consumer Protection.  Additionally, you must be diagnosed with one of the following qualifying conditions: Cancer, Glaucoma, Positive Status for HIV/AIDS, Parkinson’s Disease, Multiple Sclerosis, Damage to the Nervous Tissue of the Spinal Cord, Epilepsy, Cachexia / Wasting Syndrome, Crohn’s Disease, Post-Traumatic Stress Disorder (PTSD), Sickle Cell Disease, Post Laminectomy Syndrome with Chronic Radiculopathy, Severe Psoriasis and Psoriatic Arthritis, Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s Disease), Ulcerative Colitis, Complex Regional Pain Syndrome, Cerebral Palsy, Cystic Fibrosis, Irreversible Spinal Cord Injury, Terminal Illness Requiring End-Of-Life Care, Uncontrolled Intractable Seizure Disorder.

In March 2018, Connecticut residents proposed a House Bill (Raised Bill No. 5458) that would have allowed the retail sale of recreational marijuana to adults over 21.  However, the bill was rejected by an 11-6 vote.


In Delaware, medical marijuana sales total $7.1 million.  The Delaware Medical Marijuana Act allows physicians to authorize the use of medical cannabis to treat the symptoms of qualifying conditions.  Medical cannabis patients are permitted to possess up to 6 ounces at once.  Qualifying adolescent patients under the age of 18 cannot possess a cannabis plant, but are allowed to possess cannabis oils with no more than 7% THC with not less than 15% CBD or exactly 15% CBD.

Delaware allows for one dispensary per county to be chosen via a competitive bidding process.  This allows for just 3 dispensaries in the entire state.  Registered compassionate care centers must operate on a not for profit basis, may not dispense more than 3 oz. of marijuana to a single patient in any 14 day period, and may not employ anyone under 21.  Patients must designate one of the three compassion centers and only use that center.


In Florida, medical marijuana sales total $17.4 million.  Florida voters created their medical cannabis program by passing Amendment 2 in 2016.  The goal of the program was to offer medical cannabis consumers access to a safe sufficient and consistent supply of medical cannabis at a price that prevents black markets.

Florida’s MMJ laws give patients who are diagnosed with a set of specified debilitating medical conditions legal protection under the Florida Medical Marijuana Legalization Initiative.  To become a medical marijuana patient in Florida, you must be a Florida resident, have been diagnosed with a debilitating medical condition by a certified physician, be registered with the Department of Health, and have tried other treatments without success.


In Hawaii, medical marijuana sales total $17.2 million.  Hawaii’s Medical Cannabis Registry Program was created by Act 228 (Session Laws of Hawaii 2000).  To qualify for medical cannabis in Hawaii, you must have a debilitating medical condition, have a physician certify your condition and assist your with the application process, and have a valid ID.

Registered patients and caregivers are prohibited from acquiring, possessing, cultivating, using, distributing, or transporting cannabis or paraphernalia in public places including public parks, beaches, recreation center, youth centers, or school grounds and in any moving vehicle.


In Illinois, medical marijuana sales total $91.1 million.  The Illinois medical cannabis program was started over two years ago.  Over 34,700 people have applied for the program, which allowed patients who have been diagnosed with one of 41 debilitating conditions to have access to medical cannabis.

In April, a panel of experts met to discuss the successes and shortcomings of Illinois’ pilot program.  Dr. Rahul Khare, CEO of Innovative Care Express in Lincoln Park, noted that Illinois’ program has been hampered by doctors who are uncomfortable prescribing cannabis to patients who could potentially benefit from the drug. Dr. Khare said this results from a general wariness in the community over a lack of research into the drug’s effects, which stems from its quasi-legal status.

Rosa Nicolosi, a patient care manager at a medical cannabis dispensary in the Illinois Medical District who is also a medical cannabis patient, said Illinois’ program currently only allows people to register at one dispensary at a time, which can be inconvenient for some patients. She added that dispensaries can only carry cannabis that has been grown in Illinois.  These strict guidelines can affect a patient’s ability to access their medicine.


In Michigan, medical marijuana sales total $633 million.  The medical use of marijuana in Michigan is regulated by the Michigan Medical Marihuana Act.  Under Michigan law, any patient that has a debilitating condition and his or her primary caregiver is permitted to possess, cultivate, manufacture, use, deliver, or transfer cannabis or paraphernalia to treat or improve the qualifying patient’s medical condition.  The law allows medical marijuana patient to possess 2.5 ounces of usable marijuana and 12 marijuana plant in a locked room.

The Act restrict medical marijuana use on a school bus, on school grounds, or in correctional centers. Additionally, undertaking any task under the influence of marijuana constitutes negligence or professional malpractice.

Michigan legalized medical marijuana in 2008. Initially, the program was lightly regulated. In 2016, legislators passed a law imposing new rules, requiring currently-operating medical marijuana businesses to submit new applications to remain open. The state’s Bureau of Medical Marihuana Regulation (BMMR) was responsible for processing the roughly 600 applications that came in by the initial February 2018 deadline. The BMMR intended to process those application by June 15, was unable to issue even a single license that date.

The state extended the deadline until September 15th and was able to approve 37 licenses within that time frame. Michigan then passed emergency rules that allowed dispensaries that submitted their initial application in February, got approval from their local government, and submitted their second application in June to continue operating until December 15. This will allow 108 cannabis businesses to continue operating until the licensing process is sorted out.

Unfortunately, some of Michigan’s other marijuana businesses are being forced to close. In September, the state sent 98 cease and desist letters to dispensaries who submitted their initial paperwork, but did not follow through with the subsequent process.

Michigan’s BMMR executive director Andrew Brisbo initially did not plan to extend the licensing deadline past September, but allowed the extension after legistors expressed concern over their constituents having access to their medicine.


The Ohio legislature passed House Bill 523, effective September 8, 2016, which legalizes medical marijuana in Ohio for people with certain medical conditions who are recommended by an Ohio-licensed physician who is certified by the State Medical Board.

While this legislation set up a basic framework for the program, the task of establishing the state’s program was left to different state agencies.

As Ohio’s Medical Marijuana Control Program is still being set up, interested parties can get information online from https://www.medicalmarijuana.ohio.gov/ or by calling 1-833-4OH-MMCP. The latest estimates indicate that the program will be ready in 2019.

Nationwide Studies

Overall, this country’s medical marijuana programs have been a success.  In addition to the revenue that cannabis businesses bring to state and local governments, numerous studies have found that legalized medical marijuana has had positive social effects:

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One thought on “An Overview of Cannabis Programs in Key States

  1. Demographics of marijuana is different in each and every states of America as we can see that some states have legalized and others have yet to do so. Beside that there are consumption rates penalties as well for not following the rules and guidelines for consuming marijuana.

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