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The Senate has approved a bill that includes an provision to allow doctors at the U.S. Department of Veterans Affairs (VA) to issue medical marijuana recommendations to veterans living in legal states—setting the stage for conference with the House, which has separately advanced similar language in its own version of the appropriations legislation.
Senators approved the Military Construction, Veterans Affairs, and Related Agencies (MilConVA) measure with the cannabis amendment from Sen. Jeff Merkley (D-OR) as part of a “minibus” package of three spending bills on Wednesday. The vote was 82-15.
This comes about three months after the House passed its MilConVA bill with an amendment sponsored by Rep. Brian Mast (R-FL) and other members of the Congressional Cannabis Caucus that would also give VA doctors the ability to recommend medical cannabis to veterans.
But the exact language of the proposals are slightly different, meaning the issue will need to be reconciled in a bicameral conference committee or otherwise negotiated by House and Senate leaders as part of a final bill to be sent to the president before potentially being enacted into law. A similar situation played out in 2016, with both chambers including differing versions of the VA marijuana amendment in their appropriations bills, only to have the issue completely stripped out of the final deal that was signed into law.
“Veterans face too many roadblocks in getting the care they need and deserve. That’s why I have consistently led an effort to ensure VA doctors are able to discuss the full range of legal treatment options with their patients,” Merkley told Marijuana Moment. “Outdated laws should never censor veterans’ doctor-patient relationships. I look forward to working with colleagues on both sides of the aisle in the House and Senate to make this the time we make this important option a reality for America’s veterans.”
Here’s the veterans cannabis provision as passed by the Senate:
Sec. 260. None of the funds appropriated or otherwise made available to the Department of Veterans Affairs in this Act may be used in a manner that would—
(1) interfere with the ability of a veteran to participate in a medicinal marijuana program approved by a State;
(2) deny any services from the Department to a veteran who is participating in such a program; or
(3) limit or interfere with the ability of a health care provider of the Department to make appropriate recommendations, fill out forms, or take steps to comply with such a program.
And here’s what the House included in its MilConVA bill:
Sec. 421. None of the funds appropriated or otherwise made available to the Department of Veterans Affairs in this Act may be used to enforce Veterans Health Directive 1315 as it relates to— (1) the policy stating that “VHA providers are prohibited from completing forms or registering Veterans for participation in a State-approved marijuana program”; (2) the directive for the “Deputy Under Secretary for Health for Operations and Management” to ensure that “medical facility Directors are aware that it is VHA policy for providers to assess Veteran use of marijuana but providers are prohibited from recommending, making referrals to or completing paperwork for Veteran participation in State marijuana programs”; and
(3) the directive for the “VA Medical Facility Director” to ensure that “VA facility staff are aware of the following”“[t]he prohibition on recommending, making referrals to or completing forms and registering Veterans for participation in State-approved marijuana programs”.
“We need to start conferencing our appropriations bills,” Senate Appropriations Committee Chair Patty Murray (D-WA) said in a press release on Wednesday. “That will require House Republicans to get serious about governing, get back to the spending agreement they negotiated, and work with us to finalize bipartisan bills that meet this moment and address the needs of our families.”
Funding for federal agencies is currently set to expire on November 17 as part of a short-term extension that lawmakers approved in September.
The veterans cannabis amendment would achieve the same policy outcome as a standalone bill that was refiled on the House side by Mast and Rep. Earl Blumenauer (D-OR).
The Veterans Equal Access Act has been introduced several times in recent years with bipartisan support—and moved through committee and floor approval a number of times—but has yet to be enacted.
In August, bipartisan congressional lawmakers expressed “deep concern” over the recently updated VA marijuana directive that continues to prohibit its doctors from making medical cannabis recommendations to veterans living in states where it’s legal.
They said the decision to maintain the “harmful policy” on cannabis recommendations is especially “alarming” in the context of VA’s latest clinical guidance on PTSD, which strongly recommends against using medical cannabis as a treatment option.
“Many veterans already report using cannabis for medical purposes as a substitute for prescription drugs and their side effects,” they said, adding that a recent survey of veterans who use cannabis found that they report improved quality of life and reduced use of certain prescription drugs, including opioids.
VA has updated its cannabis guidance before, adding language in its 2017 version that explicitly encouraged VA doctors to discuss veterans’ marijuana use, for example.
In April, Senate Republicans separately blocked a procedural vote to advance a bill to the floor that would promote VA research into the therapeutic effects of marijuana for military veterans with conditions such as post-traumatic stress disorder (PTSD).