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Medicare for All Must Include Cannabis Coverage

Medicare for All Must Include Cannabis Coverage
PHOTO Molly Adams

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Medicare for All Must Include Cannabis Coverage

Even in states that have legalized the medicinal use of cannabis, the insurance industry is not providing coverage to help with the cost. Advocates are now starting to demand legislation to include cannabis coverage in health insurance — with Canada as a model.

Three words have been circulating in the political sphere since the 2020 presidential campaign picked up speed: “Medicare For All.”

The prevalence of the term, which many Democrats have endorsed as a solution to the United States’ health coverage dilemma because it would create a universal health care system, exemplifies how the American mainstream has begun to embrace a progressive agenda — an agenda that also includes support for legal cannabis.

The Bernie Sanders 2016 presidential campaign first put forth the idea of “Medicare For All.” In 2016, Sanders also endorsed legalizing cannabis. This time around, Sanders platform on the two issues has remained as progressive as ever. However, in much of the discussion around “Medicare For All” and legalizing cannabis, the two issues have stayed relatively separate.

But there is an obvious link between these issues that only some are now starting to make: the high cost of cannabis is keeping it beyond reach for many even in states with medical marijuana programs. Advocates are starting to insist that cannabis will not have truly been liberated until it is covered in health plans, like any other legal medicine.

High Costs: Fatal Flaw in Medical Marijuana Programs

The cost of medical cannabis is clearly an issue nationwide. For example, in Minnesota, which has had a medical marijuana program since 2014, the state’s Bemidji Pioneer newspaper writes that lack of affordable access is the program’s “one major flaw.” It cited state data showing that, last year alone, more than 3,400 new patients dropped out of the program, and attributes this in large part to the high cost of medicine.

Patients told the Pioneer they spend anywhere from $200 to $700 per month on the medication. These costs could be offset if insurance companies covered medical marijuana, but they will not do so until the federal Food & Drug Administration approves it, the Minnesota Council of Health Plans told the newspaper.

In New York, however, lawmakers think they might have worked out a solution. State Sen. Diane Savino and Assemblyman Richard Gottfried, both Democrats from New York City, are pushing what the New York Post couldn’t resist calling a “doobie-ous scheme” that would require government health-insurance programs such as Medicaid, Child Health Plus, Elderly Pharmaceutical Coverage and workers’ compensation to cover cannabis as they would any prescription drug.

“It’s unfair not to cover marijuana when opioids, OxyContin and Ambien are covered,” Savino told the Post. “We have to push the envelope.”

The lawmakers say the idea would help address the opioid crisis that is gripping the state, like all too many across the country.  “For thousands of patients, medical marijuana is a safer and more effective medication than other drugs, especially opioids,” Gottfried told the newspaper.

The high prices of cannabis are also an issue in California, the state that pioneered legal medical marijuana with Proposition 215 in 1996. Ironically, “compassionate care” cannabis — marijuana donated to needy medical users — has been dealt a blow by the general legalization approved by voters in 2016. The high taxes on legal cannabis have closed space for compassionate care. A bill to provide tax relief for medicinal cannabis failed to pass in Sacramento last year, vetoed by then-governor Jerry Brown.

Workers Comp Can Reimburse Employees for Medical Marijuana

A breakthrough was reported from New Hampshire this month, as the state’s Supreme Court ruled that a labor appeals board had erred in its judgment that workers’ compensation insurance cannot reimburse an employee for the cost of medical marijuana.

As Insurance Journal reports, the court found that under the state’s 2013 medical marijuana law, a carrier is not barred from reimbursing. It further found that a qualified patient is entitled to cannabis under state law. The court did send the case back to the workers’ compensation board for further consideration of the effect of federal law on the question.

The case concerned Andrew Panaggio, who registered in the medical marijuana program after he hurt his back on the job in 2016. He sought reimbursement through workers’ comp, but his carrier, CNA Insurance Co, turned down the claim on the ground that “medical marijuana is not reasonable/necessary or causally related” to his injury. Panaggio challenged the denial before the New Hampshire Department of Labor — where a case officer sided with CNA Insurance.

Panaggio then appealed to the Department’s Workers’ Compensation Board. Following a hearing, the board acknowledged Panaggio’s testimony that “cannabis is palliative and has the added benefit of reducing his need for opiates,” unanimously finding that Panaggio’s “use is reasonable and medically necessary.” Despite this, however, a majority of the board upheld the CNA’s refusal to reimburse Panaggio, because such reimbursement is “not legal under state or federal law.” Following the high court decision, the state law argument, at least, is shot down.

While the case appears to be a win for worker’s rights as they relate to cannabis, Panaggio also had to pay for his medical marijuana out of his own pocket, without help from his insurance company. If he lived in Canada, perhaps, this would not be the case.

Canada Leads the Way on Cannabis & Health Insurance

In Canada, which launched its adult-use legal cannabis industry in October 2017, insurance coverage of medical marijuana is making big advances. Last year, Sun Life Financial of Toronto became the country’s first major insurance carrier to offer coverage for cannabis. Sun Life chief executive Dean Connor said the move was prompted by rising demands from clients — especially those suffering from cancer, multiple sclerosis or rheumatoid arthritis, or those requiring palliative care.

“Medical marijuana has become a very important part of their treatment program and pain management program,” Connor told Canada’s Financial Post.

And effective this year, the life insurance arm of Quebec’s SSQ Insurance has started offering employers and other plan sponsors the option of covering medical cannabis, as TheGrowthOp cannabis industry site notes.

Even in Canada, it has been a long haul to this progress. The Canadian Broadcasting Corporation recently profiled the case of Melissa Ellsworth, who struggled against the bureaucracy for five years before the Workers’ Compensation Board of Nova Scotia finally started paying for the cannabis she uses to treat chronic pain. She was finally approved in January 2018, after a tribunal found there was “sufficient evidence to conclude that the worker is entitled to medical aid in the form of medical marijuana.”

Ellsworth frankly told CBC that the ruling saved her life. “I can function every day like a normal human being instead of being crippled up in pain,” she said. “I went from 26 pills a day to cannabis.”

It will certainly be a far bigger struggle to win this kind of progress in the more puritanical United States. But it starts with advocates pushing to include cannabis coverage as a basic plank of the progressive agenda.

TELL US, do you think cannabis coverage should be included in health insurance?

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