Hawaii lawmakers have advanced a bill to allow qualifying patients to access medical marijuana at health facilities.
In one of the latest examples of states pursuing what’s known as “Ryan’s law”—a reference to a young medical cannabis patient in California who passed away—the Hawaii House Health Committee and Human Services & Homelessness Committee held a joint hearing on Wednesday at which members unanimously approved the legislation, with amendments.
The bill from Rep. Gregg Takayama (D) states that it’s the “intent of the legislature in enacting this chapter to support the ability of terminally ill patients and qualifying patients over sixty-five years of age with chronic diseases to safely use medical cannabis within specified health care facilities.”
While Takayama said his initial instinct was to defer the bill for action, he decided upon review of testimony that “it bears further consideration.” That includes incorporating agency recommendations to permit, rather than require, health facilities to allow medical cannabis use and exempt residential treatment centers from the proposed law.
In written testimony submitted ahead of the committee hearing, the state Office of Medical Cannabis Control and Regulation (OMCCR) said that it “supports the intent of this measure to improve access for terminally ill medical cannabis patients,” but that the strict mandate on health facilities to permit medical marijuana use in the bill as filed is problematically inflexible.
Rather than “shall permit,” the office recommended revising to “may permit” with respect to facilities’ legal obligation under the proposed law.
The state attorney general’s office, meanwhile, said, “While the bill attempts to address potential federal conflicts, mandatory accommodation could expose health care facilities to legal uncertainties, including the potential risk to federal funding or other federal enforcement consequences.”
For its part, the Marijuana Policy Project (MPP) said it “strongly support[s] allowing terminally ill patients and kupuna to use medical cannabis preparations in health care facilities.” However, the organization is “alarmed that [the bill] would restrict [medical cannabis use] in other cases.”
“As it is currently drafted, HB 1542 would force nursing homes and other health care facilities to ban conduct they may be allowing now, or may wish to allow in the future,” MPP’s Karen O’Keefe said. “No health care facility should be prohibited from allowing patients relief.”
“We strongly support allowing terminally ill patients and kupuna to use medical cannabis to be used in health care facilities and commend the Chair for addressing that need. However, we strongly urge amendments to ensure the Legislature does not prohibit facilities from: 1) allowing medical cannabis by other patients should they wish to do so; and 2) allowing vaping or smoking in a private room, where tobacco would be allowed.”
There are certain exceptions detailed in the bill. For example, medical marijuana couldn’t be used in substance misuse recovery hospitals, state hospitals or emergency departments of general acute hospitals “while the patient is receiving emergency services and care.”
Smoking and vaping cannabis would remain prohibited in health facilities under the proposal, “provided that a home health agency shall only prohibit smoking or vaping immediately before or while home health agency staff are present in the residence.”
General acute care hospitals couldn’t allow patients with a chronic disease to use medical cannabis unless they were terminally ill.
In the event that a federal regulatory agency, Justice Department or Centers for Medicare and Medicaid Services (CMS) takes enforcement action against a health facility related to the medical cannabis policy, or if they explicitly notify the facility that they’re violating federal law, the health care institution could suspend the policy.
Meanwhile in Hawaii, officials recently released a report on the potential economic impact of recreational marijuana legalization in the state, including revenue implications related to domestic and international tourism.
The report from Cannabis Public Policy Consulting—which was commissioned by the Hawaii Department of Health’s (DOH) Office of Medical Cannabis Control and Regulation—looked at a wide range of policy considerations associated with potentially legalizing adult-use marijuana in the state.
All told, researchers said survey data and comparative analyses indicate that Hawaii could see anywhere from $46-$90 million in monthly marijuana sales by year five of implementation, after accounting for a maximum 15 percent tax rate on cannabis products.
In the lead-up to the release of the report, key Hawaii lawmakers last month filed legislation that would put the issue of marijuana legalization on the ballot for voters to decide.
The move comes after repeated efforts to legalize cannabis legislatively in recent sessions have demonstrated momentum but failed before reaching the finish line to be enacted into law.
If the legislature agrees to the new plan, voters would see this on their November ballots:
“Shall the Constitution of the State of Hawaii be amended to:
(1) Authorize individuals aged twenty-one and older to use and possess personal-use amounts of cannabis; and
(2) Require the legislature to enact laws governing the use, manufacture, distribution, sale, possession, regulation, and taxation of cannabis within the State?”
If a majority of voters approved the ballot measure, cannabis legalization would take effect on July 1, 2027.
House Judiciary and Hawaiian Affairs Committee Chairman David Tarnas (D) and Senate Health and Human Services Committee Chair Joy San Buenaventura (D) are the lead sponsors of the new measures. Tarnas’s House proposal has 13 additional cosponsors.
“This is kicking this particular policy decision—very selectively—to the public for a decision,” Tarnas, who has previously sponsored legalization and other marijuana reform bills, said in an interview last month.
While Gov. Josh Green (D) supports legalizing cannabis, and polling has indicated that Hawaiians are ready for the policy change, the new measures signal that the sponsors don’t anticipate that fellow lawmakers will be ready to move forward with a legislative reform this year but may instead be inclined to defer to voters.
Putting the measure on the ballot as a constitutional amendment would require a two-thirds vote in each chamber of the legislature.
That said, Tarnas and San Buenaventura have also filed separate, more traditional statutory cannabis legalization measures for the 2026 session.
House Speaker Nadine Nakamura (D) has acknowledged broad public support for marijuana legalization, but said that some of her chamber’s members from the island of Oahu are not on board with the reform.
Hawaii’s Senate last February narrowly defeated a proposal that would have increased fivefold the amount of cannabis that a person could possess without risk of criminal charges.
Had the measure become law, it would have increased the amount of cannabis decriminalized in Hawaii from the current 3 grams up to 15 grams. Possession of any amount of marijuana up to that 15-gram limit would have been classified as a civil violation, punishable by a fine of $130.
A Senate bill that would have legalized marijuana for adults, meanwhile, ultimately stalled for the session. That measure, SB 1613, failed to make it out of committee by a legislative deadline.
While advocates felt there was sufficient support for the legalization proposal in the Senate, it’s widely believed that House lawmakers would have ultimately scuttled the measure, as they did last February with a legalization companion bill, HB 1246.
In 2024, a Senate-passed legalization bill also fizzled out in the House.
Last year’s House vote to stall the bill came just days after approval from a pair of committees at a joint hearing. Ahead of that hearing, the panels received nearly 300 pages of testimony, including from state agencies, advocacy organizations and members of the public.
Green signed separate legislation last year to allow medical marijuana caregivers to grow marijuana on behalf of up to five patients rather than the current one.
And in July, the governor signed another bill that establishes a number of new rules around hemp products in Hawaii, including a requirement that distributors and retailers obtain a registration from the Department of Health.
Lawmakers also sent a bill to the governor that would help speed the expungement process for people hoping to clear their records of past marijuana-related offenses—a proposal Green signed into law in April.
That measure, HB 132, from Tarnas, is intended to expedite expungements happening through a pilot program signed into law in 2024 by Green. Specifically, it will remove a distinction between marijuana and other Schedule V drugs for the purposes of the expungement program.
The bill’s proponents said the current wording of the law forces state officials to comb through thousands of criminal records manually in order to identify which are eligible for expungement under the pilot program.
Meanwhile, in November, Hawaii officials finalized rules that will allow medical marijuana dispensaries to sell an expanded assortment of products for patients—including dry herb vaporizers, rolling papers and grinders—while revising the state code to clarify that cannabis oils and concentrates can be marketed for inhalation.
The department also affirmed its support for federal marijuana rescheduling—a policy change that President Donald Trump ordered to be completed last month but has yet to come to fruition.
—
Marijuana Moment is tracking hundreds of cannabis, psychedelics and drug policy bills in state legislatures and Congress this year. Patreon supporters pledging at least $25/month get access to our interactive maps, charts and hearing calendar so they don’t miss any developments.
Learn more about our marijuana bill tracker and become a supporter on Patreon to get access.
—
Regulators are also launching a series of courses designed to educate physicians and other healthcare professionals about medical marijuana as the state’s cannabis program expands.
The underlying medical marijuana expansion bill signed by the governor in late June, in addition to allowing more patients to more easily access cannabis, also contains a provision that advocates find problematic.
Before lawmakers sent the legislation to Green, a conference committee revised the plan, inserting a provision to allow DOH to access medical marijuana patient records held by doctors for any reason whatsoever.
Photo courtesy of Mike Latimer.
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.
