The proposal, introduced by Joy San Buenaventura, passed unanimously in a 25–0 vote on Tuesday after clearing committee last week. The legislation is intended to support terminally ill patients and people over 65 with chronic illnesses who rely on medical cannabis, allowing healthcare facilities to adopt policies permitting its use. However, the bill stops short of requiring facilities to allow it, something advocates had hoped to see included.
Under the measure—SB 2408—several restrictions would apply. Medical cannabis could not be used in substance misuse recovery hospitals, state hospitals or emergency departments while a patient is receiving emergency treatment. Smoking and vaping marijuana would also remain prohibited in most healthcare settings, though home health agencies could only ban those activities while staff are present in a patient’s residence.
The bill also limits access in acute care hospitals. Patients with chronic illnesses could only use medical cannabis there if they are terminally ill. Additionally, healthcare facilities would be allowed to suspend their cannabis policies if federal regulators take action or notify them that such policies conflict with federal law. Agencies that could trigger that response include the U.S. Department of Justice and the Centers for Medicare & Medicaid Services.
The legislation is advancing alongside other cannabis-related proposals being debated in Hawaii this year. One bill recently approved by a Senate committee would allow patients to access medical marijuana immediately after submitting their registration, rather than waiting for their physical card to arrive.
Lawmakers have also discussed broader reforms, including a proposal to legalize low-dose cannabis products for adults 21 and older. That plan would permit limited amounts of low-THC products containing up to five milligrams of THC per serving.
Despite those discussions, leaders in the Hawaii House of Representatives have indicated that full marijuana legalization is unlikely to pass during the 2026 legislative session due to insufficient support. Still, recent changes signed by Josh Green have continued to expand the state’s medical cannabis program, including allowing caregivers to grow marijuana for up to five patients and streamlining the process for clearing certain past marijuana-related offenses from criminal records.
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