Will Obamacare Cover Medical Marijuana Purchases?

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Twenty states and Washington D.C. now have legalized medical marijuana. Some medical marijuana patients in these states are wondering how this will interact with the health plans available under the Affordable Care Act, aka “Obamacare”.

Currently, the answer to the question of financial coverage of medical marijuana is a resounding “no” and not surprisingly, the issue boils down to money and politics.

First, marijuana is still considered a Schedule I controlled substance, and apparently will continue to hold this distinction until there are enough medical studies in existence proving that marijuana has medical value that the halls of the White House could be wallpapered with them.

Second, states are still unwilling to put themselves at risk by openly challenging the U.S. Pharmacopeial Guidelines by mandating that insurance companies have provisions in place to pay for medical marijuana like a pharmaceutical drug. Although the states have rights and may not be concerned about Federal opinion or offense, they are concerned about a potential lack of federal funds.

Speaking of funds, the insurance companies were all but tripping over themselves to make their plans more affordable, which translates into “How many services can we cut as we raise the premiums and still stay within the guidelines of the Affordable Care Act?” Those guidelines include 10 essential benefits that must be covered, one of those benefits being medications.

It isn’t cheap to have a medication included on the list. It is even more expensive to include an “experimental medication”, which is how marijuana would be classified, despite a couple thousand years of history proving the contrary. Insurance companies are already being forced to take on policies they don’t want to, so it might be pushing the bar a bit to assume that they are going to take on any medications they don’t want to, especially if it might cost them money.

The Affordable Care Act includes a set of guidelines meant to prevent consumers from being ripped off by insurance companies who care more about their profit margins than their customers. Insurance companies now have to show a relationship between their profits and what they offer their customers so that they aren’t top-heavy with profits while the customers aren’t getting their needs met. Comparatively speaking, marijuana is one of the least expensive medications, and although insurance companies are all about creating return customers by honoring their need for medications, they prefer the more expensive ones.

Assuming for a moment that the federal government actually responds to the call of its citizens and removes the Schedule I designation, there are still more issues to consider. Some marijuana medicines, like isolated-CBD strains, may be approved for coverage while others are not.