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- ⚕️🌿 Medical States To Watch In 2026
⚕️🌿 Medical States To Watch In 2026
GM Everyone,
The “Medical Middle” explained below.
💸 The Tape
In cannabis policy, “medical marijuana” can mean anything from a tightly rationed oil program to a voter-approved system still stuck in regulatory traffic. As 2026 gets underway, Iowa, Georgia, and Nebraska illustrate the full spectrum: one program running (with training wheels), one program dispensing (with a very strict dress code), and one program legalized (but not yet fully operational).
Iowa: A functioning program—by Iowa standards (which are intentionally conservative)
What happened in prior years: Iowa’s program has long been framed as “medical cannabidiol,” and the state has repeatedly drawn bright lines around form factors and THC access. A major turning point came when Iowa replaced a product-based potency cap with a purchase-limit model, allowing patients to buy up to 4.5 grams of THC every 90 days, with limited exceptions and a waiver pathway.
Current status (2026): Iowa’s medical cannabis system is operational and regulated through the Iowa Department of Health and Human Services (HHS). Patients can access products through five dispensaries statewide, and the state continues to administer the program with an emphasis on compliance and controlled access rather than broad commercialization.
On the patient side, the state’s framework is clear: standard purchase limits apply, and higher THC allotments generally require specific circumstances (e.g., terminal illness or post-participation practitioner certification via waiver).
The practical takeaway: Iowa is “medical,” but it is not “flexible.” The program works—especially for patients whose needs align with the approved product categories and limits—but remains constrained compared to more comprehensive medical markets.
Georgia: Legal access exists—just don’t expect flower, edibles, or a “California menu”
What happened in prior years: Georgia began with a Low THC Oil Registry model and gradually moved toward a regulated, in-state dispensing framework. The defining feature remains the product limitation: low-THC oil and related preparations, with strict THC caps and a patient registry card system. Expansion has been incremental, and the program has often felt more like a cautious medical pilot than a fully realized medical marketplace.
Current status (2026): Georgia’s medical cannabis system is active and dispensing, with the state continuing to build out licensed locations and operational infrastructure. Regulators have steadily expanded the number of dispensing licenses, signaling that the market is widening geographically even if the product scope remains narrow. The state’s strategy is clear: keep the program tightly bounded, scale access slowly, and minimize political controversy by avoiding broader product categories.
The practical takeaway: Georgia offers real, regulated access—but it’s a limited-access program by statute. Patients who benefit from measured-dose oils can participate meaningfully. Patients who want flower, broader formulations, or a more expansive list of options will find Georgia’s program structured to keep the menu short and the rules strict.
Nebraska: Voters said “yes,” implementation said “not so fast”
What happened in prior years: Nebraska voters approved medical marijuana legalization via ballot in 2024, a major shift for a state that had previously resisted cannabis reform. But as any veteran of ballot-driven cannabis policy knows, passing the measure is the opening act. The main event is implementation: regulations, licensing, timelines, and—often—litigation.
Current status (2026): Nebraska is still in the build phase. The state has moved into commission-led rulemaking and early licensing discussions, but patient access depends on the speed and stability of implementation. The biggest story entering 2026 is that Nebraska’s program is moving forward, but under a cloud of delays and disputes that have slowed the transition from “legal framework” to “operational marketplace.”
The practical takeaway: Nebraska is best described as “legal on paper, developing in practice.” The key question for 2026 is whether regulators and stakeholders can turn the statutory framework into an actual supply chain—cultivation, manufacturing, testing, and dispensing—without further procedural or legal setbacks.
What to watch in 2026
Iowa: Any push to broaden product types, increase purchase allowances, or expand dispensary access beyond the current controlled footprint.
Georgia: Continued buildout of dispensing locations and any legislative effort to expand qualifying conditions or product categories.
Nebraska: Licensing cadence, regulatory timelines, and whether implementation accelerates enough for patients to see meaningful, reliable access during 2026.
Three states, three philosophies. Same “medical” label, entirely different operating manuals.
📈 Dog Walkers
Policy Maker Want To Keep Weed Out of D.C.
Congressional leaders have reached an agreement on yet another must-pass spending bill—and once again, cannabis policy finds itself caught in the margins of federal budgeting rather than debated on its merits.
The newly released Fiscal Year 2026 appropriations package includes language that continues to prohibit Washington, D.C. from establishing regulated adult-use marijuana sales, despite local voters approving legalization more than a decade ago. The restriction, championed for years by Rep. Andy Harris (R-MD), survives intact—suggesting that congressional leadership sees little urgency in revisiting a policy that overrides local democratic outcomes.
At the same time, the bill’s accompanying report takes pains to remind District officials that marijuana remains illegal under federal law, including enhanced penalties for cannabis activity within 1,000 feet of schools, playgrounds, and universities. The message is less subtle than usual: proceed cautiously, and preferably not at all.
Ironically, this posture may soon be overtaken by events. If the Trump administration finalizes its plan to reclassify cannabis from Schedule I to Schedule III, the legal foundation of the D.C. sales ban becomes considerably shakier. The Congressional Research Service has already acknowledged that rescheduling would likely permit the District to authorize commercial sales and impose cannabis taxes as a matter of local law—though Congress appears intent on preserving ambiguity by extending the rider’s reach to undefined “tetrahydrocannabinols derivatives.”
In other words, the policy is both rigid and unclear, which has become something of a theme.
The spending package also ventures into cannabis-adjacent geopolitics. A separate provision directs federal agencies to produce a report on PRC-linked criminal drug syndicates allegedly involved in illicit cultivation and money laundering operations in states such as Maine, California, and Oregon. While marijuana isn’t mentioned explicitly, the geographic clues leave little doubt about the target. Congress is simultaneously blocking legal markets while commissioning reports on the consequences of illegal ones.
House Appropriations Chair Tom Cole framed the package as advancing “security, responsibility, and growth,” while Senate counterpart Susan Collins emphasized drug trafficking enforcement and financial oversight. Both statements are defensible—yet they underscore a familiar contradiction: federal lawmakers remain comfortable funding enforcement and investigations while resisting regulated frameworks that could reduce illicit activity in the first place.
Notably, this deal arrived just days after the House passed a separate spending bill continuing protections for state medical marijuana programs—while stripping out language that would have blocked federal rescheduling. That proposal now heads to the Senate, where cannabis reform often goes to wait patiently.
Taken together, the message from Congress is clear, if not coherent: cannabis reform is acceptable in theory, permissible in studies, tolerated in states—but still unwelcome when it comes to D.C., budgeting riders, or straightforward legislative accountability.
As usual, marijuana policy isn’t being debated. It’s being footnoted.
🗞️ The News
📺 YouTube
What Washington is Saying on Cannabis Rescheduling | TTB Powered by Flowhub
What we will cover:
✅ Coming up today at 4 PM Eastern, Trade to Black presented by Flowhub returns with host Shadd Dales alongside Anthony Varrell for a focus on the latest news out of Washington.
We’ll start with the latest comments from a GOP congressman pushing back on concerns that cannabis rescheduling is stalled, saying President Trump made it clear the Department of Justice must act. That raises an important question: if the directive is clear, what happens next — and what are industry participants watching for while the DEA process remains pending?
We’ll also discuss continued congressional resistance to allowing Washington, D.C. to move forward with regulated cannabis sales, highlighting the ongoing disconnect between federal oversight and local voter intent.
On the corporate side, Village Farms International (NASDAQ: VFF) announced new product innovation in the Dutch market.
Plus, Michael Bronstein, President of the American Trade Association for Cannabis and Hemp, joins us for our weekly Insider’s Edge segment. Michael will share the latest from Washington, including where things stand on cannabis scheduling and whether there’s any clearer visibility yet on Attorney General Pam Bondi formally signing off.

