House Bill 302 Will Allow Medical Cannabis Recommendations for Any Condition a Physician Deems Appropriate

Hawaii is moving closer to significant changes in its medical cannabis laws. On April 8, 2025, the state’s Senate adopted an amended version of House Bill 302 in a near-unanimous 24-1 vote. Sponsored by Representative Gregg Takayama (D-Pearl City), the bill seeks to redefine the state’s medical cannabis program by expanding the list of qualifying medical conditions to include any condition that a healthcare provider determines is appropriate for treatment with cannabis.

Currently, patients must have a specific medical condition listed in Hawaii’s statutes to be eligible for medical cannabis use. Under the proposed law, physicians and advanced practice registered nurses (APRNs) will have the discretion to recommend medical cannabis for a broader range of conditions, from minor ailments like headaches to chronic conditions such as insomnia or pain.

Opposition from the Department of Health on Expanded Medical Cannabis Use

The Hawaii Department of Health (DOH) expressed concerns over the proposed expansion. While acknowledging the value of healthcare providers using their professional judgment, the DOH raised alarms about the lack of scientific evidence supporting the use of cannabis for many conditions outside the current qualifying list. DOH officials are also wary of potential drug interactions between cannabis and patients’ existing medications, which they believe could pose safety risks.

The DOH also opposes allowing non-primary care doctors or APRNs to provide cannabis recommendations, a provision included in the bill. This aspect of the legislation could further decentralize access to medical cannabis recommendations, making it easier for patients to find healthcare providers willing to prescribe cannabis.

Streamlining Access to Medical Cannabis with Telehealth and Online Consultations

In another significant shift, the bill would allow patients to establish a “bona fide relationship” with healthcare providers through telehealth services. This provision seeks to reduce barriers to access by allowing consultations to occur remotely, making it easier for patients to receive recommendations without needing to visit a provider in person. However, telehealth certifications for medical cannabis recommendations would be required to come from within Hawaii, limiting cross-state access.

The bill also highlights the challenges that patients face in accessing licensed dispensaries, citing administrative barriers, delays in registration, and the prevalence of the illicit cannabis market. The number of registered medical cannabis patients in Hawaii has dropped by 15% since 2021, indicating a shift away from licensed dispensaries as patients turn to alternative sources.

Provisions to Combat the Illicit Cannabis Market and Expand Cultivation Licenses

In response to the growing illicit market, House Bill 302 includes provisions aimed at tightening regulation. It would make it a felony to operate a dispensary without a proper license and a misdemeanor to advertise unregulated cannabis products. Additionally, the bill would allow the Department of Health to issue additional cultivation licenses, increasing the number of licensed growers and potentially boosting supply to licensed dispensaries.

Despite these measures, the Hawaii Cannabis Industry Association (HICIA) has voiced opposition to the expansion of cultivation licenses, arguing that the current market is already constrained. HICIA, which represents many of Hawaii’s licensed dispensaries, contends that existing production facilities are underutilized, and that the introduction of new cultivation licenses could flood the market, exacerbating the current imbalance between supply and demand.

Legalizing Non-Cannabis Products in Dispensaries to Improve Revenue and Efficiency

Other provisions in the bill would allow licensed dispensaries to sell non-cannabis items in their waiting areas, such as hemp products and paraphernalia. This is seen as a way to generate additional revenue for dispensaries and provide customers with a broader range of legal products. The bill also includes measures to clarify dispensary-to-dispensary sales, potentially improving the efficiency of product distribution.

Governor Josh Green Likely to Sign the Bill into Law if Passed

If the House concurs with the Senate’s amendments, Governor Josh Green is expected to sign the bill into law. Green, who supported adult-use cannabis legalization during his 2023 campaign, has expressed interest in expanding access to medical cannabis as a potential middle ground between adult-use legalization and concerns about public safety. In a statement last year, he noted that expanding medical cannabis access could provide a compromise between legalizing cannabis for broader use and addressing law enforcement concerns.

Despite the failure of adult-use legalization bills in the past two years, this shift toward expanding medical cannabis access signals a new direction for cannabis reform in Hawaii. Green’s support for the bill aligns with his broader agenda to make cannabis more accessible while maintaining public safety protections.

Hawaii’s Continued Conservative Stance on Adult Use Cannabis

While Hawaii has been a leader in medical cannabis reform, having legalized medical marijuana in 2000, the state has remained cautious about adult-use cannabis legalization. Despite public support for recreational cannabis use, the state has yet to pass adult-use legislation, focusing instead on expanding the medical cannabis program.

With House Bill 302 now on the verge of becoming law, Hawaii is poised to make strides toward more inclusive and accessible medical cannabis for its residents, setting the stage for further legislative debates about the future of cannabis in the state.