Minnesota’s medical marijuana program has struggled for years as the flaws in its design have caused issue after issue.

New patients are leaving the program in droves, turning to the black market or prescription opioids because they cannot afford the processed pills and oils that are legal. Growers are losing millions because of a strict tax structure written into the law.

Lawmakers can fix this, but they might have to look beyond their home state for solutions. A slew of proposals at the State Capitol could save the manufacturers money and help them lower prices. Patients say they do not go far enough.

“We need the Legislature to make this a priority,” said Maren Schroeder, co-founder of Sensible Change Minnesota, a group that wants to expand access for the more than 15,000 medical marijuana patients in the state. “The patients can’t wait for incremental changes.”

RELATED: Why the MN medical marijuana task force didn’t meet for two years.

Minnesota’s medical cannabis program is widely seen as one of the most restrictive in the country; the costly drugs are not insured and only patients with one of 13 severe conditions can use them.

Is there a commitment to shed that reputation?

Minnesota Gov. Tim Walz told the Pioneer Press that he would support legislative changes to the program, which he said is “very cumbersome” and “doesn’t work.”

“It felt like they did the bare minimum they could do just to kind of limp over,” Walz said, referring to the compromise that lawmakers and former Gov. Mark Dayton struck to legalize medical marijuana in 2014. “Now we’re stuck with a very minimal medicinal cannabis (program) that really is too expensive.”

Leaders in the Democratic House and Republican Senate are also on board.

House Majority Leader Ryan Winkler, DFL-Golden Valley, said his chamber will pass “some reforms to medical marijuana to make sure that patients have … better access than they do now.”

Deputy Senate Majority Leader Michelle Benson, R-Ham Lake, said her chamber is open to changes.

WHAT OTHER STATES ARE DOING

Minnesota is not the only state to deal with growing pains. Some just dealt with theirs sooner.

When Pennsylvania rolled out its medical marijuana program last February, it had the same flaw: the processed pills and oils were too costly for patients.

The average patient shelled out $300 when he or she went to a dispensary, according to the Pennsylvania Department of Health. In contrast, most patients who spoke to the Pioneer Press say they spend between $200 and $500 per month.

In August, Pennsylvania officials made a major change to the program. They legalized the marijuana plant for medicinal use, and prices began to drop. By Feb. 1, the average cost per patient on a trip to a dispensary had fallen to $130.

Among the 33 states that have legalized medical marijuana, Minnesota is one of just a few that have outlawed the dried plant. The manufacturers here have to process the plants into pills and oils before they can sell them, which ups their operating costs.

Many patients say they would prefer to use the real plant, and the state’s two manufacturers admit it would be cheaper to sell.

“It certainly would solve a lot of problems,” said Jay Westwater, CEO of Minnesota Medical Solutions. “We think the costs for those people would probably be close to half.”

Critics counter that the plant is hard to dose, and police could mistake it as illegal.

“If you’re talking about someone being able to walk into a dispensary and get a bag of grass … we’re opposed to that,” said Dennis Flaherty, executive director of the Minnesota Police and Peace Officers Association. His group opposed a broader medical marijuana bill back in 2014 that would have created a more robust program.

In New Mexico, lawmakers are mulling a state subsidy for low-income people who cannot afford medical cannabis.

Chris Tholkes, interim director of the Minnesota Office of Medical Cannabis, said she is open to this idea for patients who are poor, elderly or disabled.

“That’s a conversation that we’d be willing to have as well,” Tholkes said. “(The Department of Human Services) currently pays a lot for coverage of opioids. Could we do something with them as well?”

WHAT MINNESOTA LAWMAKERS WANT TO DO

State lawmakers say they want to fix up the program, but they are taking it in steps.

Bills that would improve patient access and ease restrictions on producers have been discussed at the Capitol, and they have bipartisan support. There are no proposals to legalize the dried flower or create a subsidy, however.

Among the proposals:

A bill that would let the manufacturers open four new dispensaries each. This would give rural patients better access; there are now eight dispensaries in the state, and four of them are in the Twin Cities metro.

A bill that would let the manufacturers write off business expenses like any other company. The law as it stands prevents them from doing so and has led to higher operating costs that get passed on to patients.

A bill that would let state hemp farmers sell their product to the medical cannabis manufacturers.

Westwater said these proposals will help bring down operating costs for the manufacturers. The two companies would see combined savings of hundreds of thousands of dollars per year if the tax structure changed, he said.

But he stopped short of saying it would result in lower prices at the dispensaries.

“I would love to say that I can channel all those savings right into patient savings. I can’t make those promises,” said Westwater, whose company will post a loss for 2018.

These bills have moved in both chambers and are very much alive at the Capitol.

State Rep. Heather Edelson, DFL-Edina, is carrying the bill that would add more dispensaries and bring hemp into the fold. Discussions over more reforms, such as legalizing the dried flower, will carry into next year, she said.

“I am open to discussions on that,” Edelson said. “It will actually bring the costs down significantly.”

‘NO ONE IS HEARING ABOUT THE PATIENTS’

Patients say these proposals meet the needs of the manufacturers but not their own.

“All the appropriations and all the improvements that they’re making revolve around the manufacturers and dispensaries,” said Paul Johnson, a former medical cannabis patient from St. Paul who has turned to the cheaper black market. “No one is hearing about the patients. Where’s the focus on them?”

Schroeder, of Sensible Change Minnesota, agreed, saying that lawmakers are doubling down on a failing model.

Her group is advocating for more expansive reforms. They want the state to legalize the dried flower, open the market to more producers and reduce patient registration fees, among other things.

“We’re not getting the actual traction that we need to make this be done right,” Schroeder said.

Others argue that full legalization may be the best fix.

Deanna Jean Ryther of Lansing has taken medical cannabis for her traumatic brain injury. The medical market has been unaffordable and inaccessible for her.

Legalization would create a more robust market with lower prices and more dispensaries, she said.

“People are desperate, and we desperately want to see the market change here in Minnesota,” Ryther said. “We’re missing out on a lot, and it’s a disservice to people who are genuinely suffering and looking for relief.”

This report is the third in a series that takes a deep look at Minnesota’s medical marijuana program.