On Thursday, voters in Missouri had a choice between three different medical cannabis measures. And with a 65 to 35 percent margin, they approved Amendment 2—the measure that provides the broadest access to medical cannabis. Amendment 2 opens up access to medical cannabis for all Missourians, leaving the decision of whether or not to recommend a medical cannabis treatment entirely up to physicians and their patients. With this historic vote, Missouri joins Utah and Michigan as the latest states to legalize some form of cannabis, brining the national total up to 33 (plus D.C. and U.S. territories).

Missouri Says Yes to Amendment 2, Legalizing Access to Medical Cannabis

New Approach Missouri, an advocacy group that spearheaded the effort to back Amendment 2, is calling Thursday’s election results a resounding victory for Missouri’s patients and caregivers. Unlike Amendment 3 and Proposition C, the other two medical marijuana ballot measures, Amendment 2 puts doctors and patients in charge of medical cannabis decisions, sidelining politicians and government bureaucrats. However, it will still be up to lawmakers and state agencies to swiftly and effectively implement Amendment 2.

But there is a timeline in place. The state will have to begin accepting applications for qualifying patients no later than June 4, 2019. For dispensary license applications, the state must begin accepting dispensary applications no later than August 3, 2019. And the state must decide on dispensary applications within 150 days of receiving them. In short, these dates mean that patients will be able to start growing their own cannabis before products are available for sale in dispensaries.

The election brings an end to a long process of fighting for medical cannabis access in Missouri. But many expected the state to pass some form of medical cannabis this year due to popular support. In late August, when all three ballot measures received approval from Secretary of State Jay Ashcroft, it became clear that the question was not whether Missourians would legalize medical marijuana, but which path legalization would take. Big money was behind both amendments. New Approach Missouri raised more than $1.5 million, according to one source, which included $250,000 from a New York nonprofit called Drug Policy Action. Opposition groups raised just $6,000 to oppose medical cannabis legalization.

The Specifics of Missouri’s New Medical Marijuana Amendment

Amendment 2 creates a medical cannabis program that an already-existing government office, the Department of Health and Senior Services, will regulate and oversee. The Department of Health and Senior Services will thus be in charge of issuing licenses for dispensaries as well as for cultivation, testing, and manufacturing operations. This is different than Amendment 3, which would have created a new Medical Research Board run by one man, Brad Bradshaw.

Bradshaw is a personal injury lawyer and doctor who sponsored and funded Amendment 3, which would have taxed medical cannabis patients at 15 percent. That tax rate would have been the highest in the country for medical cannabis. And Bradshaw would have had total control over the appropriation of those tax dollars as well as licensing. By contrast, Amendment 2 taxes patients at a rate of 4 percent. Revenue will cover costs of implementing and regulating the program, with remaining revenue going directly to government programs that support veterans.

For patients and caregivers, Amendment 2 provides much broader access to medical cannabis than any of the alternatives. Under the new constitutional amendment, doctors will determine whether or not a patient qualifies and can benefit from medical cannabis treatments. In other words, the law sets up no list of qualifying conditions. Doctors can make recommendations for any condition they see fit.

Amendment 2 also allows the home cultivation of medical cannabis, which Amendment 3 would have prohibited. Under the newly approved law, patients and their registered caregivers can grow up to six mature cannabis plants in their private residence. Purchase limits will allow patients and caregivers to buy four ounces of cannabis from dispensaries each month.