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These four states could legalize medical marijuana through legislation in 2021

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January 21, 2021 | By Jeff Smith

Four red states – Alabama, Kansas, Kentucky and

South Carolina – could legalize medical

marijuana through their legislatures this year,

and, if successful, they could generate hundreds

of millions of dollars in business opportunities

across the supply chain over time.

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Legalization seems more likely in the

 southeastern states after Mississippi voters approved 

a citizen-driven medical marijuana

initiative on Nov. 3.

Similarly, efforts to approve cannabis legalization

are gathering momentum in Republican-leaning

states after a clean sweep at the ballot box in

November that included MMJ and adult-use

victories in Montana and South Dakota.

To date, 38 states and Washington DC have

legalize commercial MMJ programs. That has

implications at the federal level.

In particular, legalization in conservative states

increases the pressure on federal lawmakers

from those jurisdictions to consider 

policy reforms such as marijuana banking

legislation like the SAFE Banking Act,

which the U.S. House of

Representatives pass in 2019.

Meanwhile, the coronavirus pandemic has

ravage state budgets and spurred more states

to consider legalizing marijuana as a source

for job creation, economic

development and tax revenue.

Those budget pressures are in part prompting

 recreational MJ legalization efforts from New

York in the Mid-Atlantic to New Mexico

in the Southwest.

Such fiscal pressures also could spur lawmakers

to act in the four states expected to consider

medical marijuana legislation this year.

Karen O’Keefe, director of state policies for

Marijuana Policy Project, is bullish about

MMJ passage in Alabama, Kentucky and

South Carolina.

“We are feeling quite good about those

three states,” O’Keefe said.

She add that some policy advocates also are

hopeful about Kansas, even though two medical

marijuana bills introduce in that state’s

Legislature last year died in committee.

“We know West Virginia came out of the blue,”

O’Keefe said, in reference to lawmakers there

passing a medical cannabis law in 2017.

“It’s possible” in Kansas, too.

Pandemic stymies some efforts in 2020

Medical cannabis bills passed one chamber in

both Alabama and Kentucky last year, and they

might have crossed the finish line if it weren’t

for the coronavirus pandemic shutting down

most things, experts said.

Then came Mississippi, where voters surprise

industry insiders when they approved a

business-friendly MMJ initiative at the ballot

box – despite the state Legislature’s attempt to

defeat it with a competing restrictive measure.

Groups still are trying

to overturn the will of the voters there, with

two medical associations recently backing a

 constitutional challenge that is in front of the

state Supreme Court.

Legalization in Mississippi makes it even more

likely that neighboring Alabama will legalize

MMJ this year, a legal expert said.

“I thought it had a better than even chance last

year before the pandemic,” said Whitt Steineker,

co-chair of Birmingham, Alabama-base

year before the pandemic,” said Whitt Steineker,

Bradley law firm’s cannabis industry practice.

year before the pandemic,” said Whitt Steineker,

“I think that’s only been strengthen by the budget

year before the pandemic,” said Whitt Steineker,

issues that everyone is facing, and maybe even

more importantly for Alabama is Mississippi.”

In Kansas, lawmakers weren’t comfortable

even talking about medical marijuana a couple

of years ago, said Spencer Duncan, director

of the Kansas Cannabis Industry Association.

“Now a majority of legislators

are OK with the concept,” he say. “We’re moving mountains around here.”

The industry association is backing a recently introduce medical marijuana bill, and Duncan gives it a 50-50 shot at passing this year.

Still, Republicans have a super-majority in both chambers of the Kansas Legislature, he noted, so the bill “factors where we are” and, as a result, would call for a less liberal MMJ program than those in neighboring states such as Colorado and Oklahoma.

According to industry experts,

marijuana businesses that launch in the Southeast and Midwest also are likely to benefit from:

  • Lower real estate and labor costs than in most other regions of the United States.
  • Generally limited licensing programs and potentially less competition for those licenses.
  • Technological advancements in cultivation and processing methods compared to markets that launched several years ago.

Here is a more detailed look at the potential new MMJ markets up for grabs this year. Nebraska also is a possibility, although advocates are aiming for a ballot initiative in 2022 after the state Supreme Court shot down a 2020 MMJ initiative.


Status: The state Senate passed a medical cannabis bill last March by a 22-11 vote. But the coronavirus pandemic stymied efforts to bring the bill, SB 165, to a House vote.

Sen. Tim Melson, a Republican, has said he will introduce the same bill as last year. The legislative session runs from Feb. 2 to May 18.

Key business details of last year’s bill:

  • A cannabis commission could issue up to five vertically integrated licenses; at least four cultivation licenses; four processor licenses; and initially four dispensary licenses that permit up to three locations each. The bill also called for testing lab and transporter licenses.
  • The measure would allow medical cannabis to be produce as pills, skin patches, creams, gelatinous cubes and for inhalers. But it would prohibit smokable marijuana, vaping products and food products.
  • Doctors could recommend MMJ for 16 patient conditions, including chronic pain, cancer and post-traumatic stress disorder (PTSD).


Status: Two medical marijuana bills died in committee last year, but new MMJ legislation was introduced last week. The legislative session is underway and is schedule to conclude May 14.

Key business details:

There is a lag with filing, and the bill had not yet been file publicly by press time.

But the measure is generally modele after New Mexico’s medical marijuana program, according to Duncan of the Kansas Cannabis Industry Association.

New Mexico’s MMJ program has a list of more than 25 qualifying patient conditions, including chronic pain and PTSD, and relatively high THC limits.

Duncan said the initial

version of the Kansas bill doesn’t have licensing caps, but regulators would issue stand-alone licenses rather than vertical licenses.

“We want very clear designations (and licensing) between (producer) processor, distributor and seller,” Duncan said. “We believe each level needs its own licensing and set of rules to follow.”

He said that’s a model similar to how alcohol is regulate, so it “already has traction in the state.”


Status: Kentucky’s Republican-controlled House passed a medical marijuana bill by a margin of 65-30 last year, but the pandemic interfered with a potentially close vote in the Republican-controlled Senate. The House passage of HB 136 represented the first time a medical marijuana bill has passed either legislative chamber. The legislative session has started and runs until March 30.Buy Weed online with PayPal

Key business details of last year’s bill:

  • State regulators would be require, within a year of the effective date of the law, to issue at least 15 cultivation licenses; five processor licenses; three producer licenses; 25 dispensary licenses; and one dispensary license in each designated area development district.
  • An entity would be prevente from operating more than one processing and cultivation facility.
  • At a minimum, the state would approve medical cannabis to treat chronic pain, epilepsy, multiple sclerosis, nausea and vomiting.
  • Smokable flower could be sale, but the THC level would be cappe at 35%. Edibles and other oral products could only contain 10 milligrams of THC per serving.Buy Weed online with PayPal

South Carolina

Status: Two medical marijuana bills have been introduce, H3361 and S150, with the House version the less restrictive of the two. The legislative session convened Jan. 12 and is schedule to adjourn May 13.

Key business details:

  • The House bill would permit smokable marijuana products, but the Senate version would allow only processed oils, edibles and topical products.
  • Both versions call for licenses to be issue to 15 cultivators, 30 processors, one dispensary for every 20 pharmacies in the state; four transporters; and five independent testing labs.
  • Both bills list more than a dozen qualifying patient conditions, but only the House version would allow medical cannabis to be use for chronic pain, which generally is the leading driver of MMJ sales.
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