Marijuana Moment: Pennsylvania Lawmakers Pass Bill Allowing Medical Marijuana Use In Hospitals By Terminally Ill Patients

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Pennsylvania lawmakers have approved a bill to allow terminally ill patients to use medical cannabis in hospitals and other healthcare facilities.

The House of Representatives passed the bill from Rep. Dan Frankel (D) in a 174-27 vote on Monday. It now heads to the Senate for consideration.

If enacted into law, HB 2254 would require hospitals, long-term care nursing facilities, assisted living residences and personal care homes to allow terminally ill patients to use medical cannabis on the premises, provided that doing so does not interfere with their broader treatment plan and that marijuana isn’t vaporized in a way that “could impact care to other patients.”

Smoking cannabis is not allowed under Pennsylvania’s broader medical marijuana law.

Within 180 days of the bill being enacted, covered healthcare facilities would have to “develop and disseminate written guidelines for the use or administration of medical marijuana.” That would need to include requirements that cannabis be stored in locked containers, safety measures to protect other patients and staff, specificity on the forms of marijuana that are allowed and procedures for documenting use.

“Today we have the opportunity to come together to ease the suffering of patients at the end of their lives,” Frankel said on the House floor ahead of the vote. “In a few moments we will cast our votes to ensure that patients nearing the end of their lives are not denied access to medical cannabis simply because they receive care in a hospital—but what House Bill 2254 really does is give some very sick people the chance to spend their final days conscious, comfortable and connected to the people they love.”

“Many of us in this chamber have sat beside the bed of a loved one in their final hours,” he said. “We know the value of one more conversation, one more squeeze of the hand, one more chance to say, ‘I love you.’ Today, with this vote, we can help give that gift to Pennsylvania families.”

The legislation says that facilities are not required to administer medical cannabis to patients to to allow its use in emergency departments, but it also says that those that facilities violate the broader policy on allowing use can be assessed a civil penalty of up to $500 for each violation for each day a violation continues.

The measure also provides that if the Department of Justice, Centers for Medicare and Medicaid Services or another federal agency takes action against a healthcare facility over the use of medical cannabis, facilities should suspend compliance with the law.

Finally, the bill would require the state Department of Human Services to prepare a sample medical marijuana plan for healthcare facilities and to host at least five educational sessions about the issue.

“The needs of terminally ill patients were a key consideration when Pennsylvania enacted the Medical Marijuana Act. The law includes provisions allowing patients in care facilities to access medical marijuana by designating a caregiver to administer and even permits facility staff to serve in that role,” Frankel wrote in a cosponsorship memo for the legislation prior to formally introducing it this session. “While some facilities in Pennsylvania have chosen to permit the use of medical marijuana, adoption remains inconsistent across the state. As a result, many terminally ill patients continue to face barriers to accessing medical cannabis during inpatient or end-of-life care.”

“This measure will ensure patients have access to effective symptom relief while maintaining safety and compliance within care settings,” he said.

The medical cannabis bill’s advancement comes as lawmakers in Pennsylvania continue to consider broader recreational marijuana legalization—a reform that a state senator recently said will be easier to achieve now that the Trump administration has rescheduled cannabis at the federal level.

Gov. Josh Shapiro (D) has repeatedly called on lawmakers to send him a marijuana legalization bill and for the last several years has included the reform in his budget requests to the legislature.

The Democratic-controlled House of Representatives passed a bill last year to end prohibition, but the Republican-controlled Senate has not followed suit.

Republican gubernatorial nominee Stacy Garrity, who is running against Shapiro, recently pledged to veto a marijuana legalization bill if lawmakers ever sent one to her desk—though she added that she doesn’t think the reform stands a chance of making it that far in the state.

“I don’t support legalizing recreational marijuana,” she said. “Recreational marijuana will not end up in the budget. They’re never going to pass it…not as long as Senate Republicans are in control of the Senate.”

Her running mate for lieutenant governor, Jason Richey, claimed that legalizing marijuana would be “catastrophic” for the state, arguing it would increase the size of the illegal market, undermine job creation and harm public health.

A spokesperson in the governor’s office said the Trump administration’s federal marijuana rescheduling move is an “important step” that “adds support” to his push to legalize cannabis in the state.

The governor also used this year’s unofficial cannabis holiday 4/20 as an opportunity to press lawmakers once again to send him a bill to legalize marijuana.

“Pennsylvanians who want to buy recreational marijuana are already driving across the border to one of our neighboring states who’ve legalized it,” Shapiro said in a social media post that day. “That’s hundreds of millions in revenue going out of state instead of being spent here in Pennsylvania.”

In April, the Pennsylvania House of Representatives passed budget legislation proposed by Shapiro that relies on revenue that would be generated from recreational marijuana sales, which has yet to be legalized in the state.

The governor earlier this year, as he has in past years, included cannabis legalization and the resulting expected revenue in his budget request. The $53.2 billion budget legislation, which doesn’t itself include provisions to actually legalize marijuana even as it contemplates allocating money that would result from it, now heads to the Senate for consideration.

The House of Representatives last year passed a bill to legalize marijuana and put sales in state-owned dispensaries, but the Republican Senate majority has criticized that plan while also not advancing a cannabis legalization model of its own.

Separately this session, lawmakers have advanced a bill to allow terminally ill patients to use medical cannabis in hospitals and other healthcare facilities

The legislative developments come as a recent poll shows that seven out of ten Pennsylvania likely voters support legalizing adult-use marijuana—including majority backing for the reform across party lines.

When asked whether they “support or oppose the regulation and taxation of legal cannabis for use by adults 21 and older in Pennsylvania,” 69 percent of respondents said yes. Support was strongest from Democrats, at 72 percent, but also includes 67 percent of Republicans and 64 percent of independents.

Meanwhile, Shapiro is continuing to pressure on lawmakers to send him a bill to legalize marijuana in the state, saying that doing so would generate new revenue that could be invested in key programs.

“While some in Harrisburg claim we can’t afford to make bigger investments in our kids, public safety, and our economy, know this: If we legalized and regulated adult-use cannabis, we’d bring in $1.3 BILLION in revenue for our Commonwealth over the first five years,” the governor said in another recent social media post.

“Those are dollars that can be invested back into our people and our communities,” he said. “Stop with the excuses. Let’s get this done.”

The state’s Independent Fiscal Office (IFO) reported in February that legalizing cannabis in Pennsylvania would generate nearly half a billion dollars in annual revenue by 2028, an estimate that is a significantly larger cash windfall compared to projections from Shapiro’s own office.

With a proposed 20 percent wholesale cannabis excise tax, 6 percent state sales tax for retail and licensing fees, IFO said the governor’s legalization plan would generate $140 million in tax revenue in the first year of implementation from 2027-2028 and increase to $432 million by 2030-2031.

That’s a much higher revenue estimate than what the governor’s office put forward in the latest executive budget. According to his office’s analysis, legalization would generate about $36.9 million in tax dollars in its first year from a 20 percent wholesale tax on marijuana—rising gradually to $223.8 million by 2030-2031.

In February, a coalition of drug policy and civil liberties organizations urged Shapiro to play a leadership role in convening legislative leaders to get the job done on cannabis legalization this session.

The Senate Law and Justice Committee last month amended and approved a bill to create a Cannabis Control Board (CCB) to oversee the state’s medical marijuana program and intoxicating hemp products and that could eventually regulate adult-use cannabis if it is legalized in the state.

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