The Best State to Live in if You Need Medical Cannabis

Which state is best for medical marijuana?


At the time of writing, 33 states plus Washington D.C. have legalized marijuana, and 11 states plus D.C. allow it for recreational use. Even in recreational states, there are advantages to holding a medical marijuana card. Depending on the state, your MMJ card may allow you to purchase more cannabis in a single transaction, pay less in tax, and grow more plants at home.

It is a sad fact that not every state medical marijuana program is up to par. There are well over three million medical marijuana patients in the United States, and not all of them experience the same level of service. Qualifying for an MMJ card involves a consultation with a licensed physician who determines if you have a medical condition that allows you to apply for the card successfully.

The list of qualifying conditions varies according to the state, but there is a total of 95 such conditions. According to the Americans for Safe Access (ASA) State of the States Report 2019, Glaucoma is by far the most frequent medical condition for a medical marijuana recommendation; a whopping 66.6% of MMJ patients cite it as their reason for needing cannabis. Muscle spasms are next at 12%, followed by nausea with 5.3% and cancer with 4.7%.

If you intend to apply for an MMJ card, or already have one, it is useful to know where your state ranks when compared with other medical marijuana programs. The ASA provides key information in this regard and releases annual reports ranking the best and worst state medical marijuana programs in the United States.

For the record, the ASA uses five criteria to ‘grade’ each program, offering a maximum of 100 points for each. This year, the ASA says it awarded an extra 40 points to any state that made an effort to use medical marijuana to combat the opioid crisis.

The five categories used are as follows:

  • Ease of navigation
  • Functionality
  • Access to medicine
  • Patient rights and civil protection from discrimination
  • Consumer safety and provider requirements

Within each broader category lay subcategories. For example, in the Discrimination section, Arrest Protection was worth 40 points.

The report even looked at the states where weed is illegal that have CBD laws, and also accounted for territories such as Guam, the United States Virgin Islands, the Commonwealth of the Northern Marinara Islands, and Puerto Rico.

As for the grades, a score of 90+ was an ‘A,’ a ‘B’ was 80+, a ‘C’ was 70+, and a ‘D’ was 60+. A score of 59% or less was classified as a Fail. Each grade was divided into plus and minus sections as well. Without further ado, let’s uncover the identity of the best state to live in for MMJ patients.

The Winner is… Illinois!

According to the ASA, the state of Illinois has the best medical marijuana program in the United States. Before the 2019 report, no state had ever achieved an ‘A’ grade, but this year, two broke past the 90% barrier. In the end, Illinois is the narrow winner with an exceptional score of 92.27%.

According to the report, Illinois has approximately 65,000 MMJ patients as of June 2019. The state already had one of the best programs in the U.S. and achieved three consecutive B+ grades before this year. Last year, Illinois began to permit medical cannabis in schools and also decreed that patients with a prescription for opioids were allowed to trade it in for medical marijuana.

In 2019, Illinois became the first state to legalize recreational use of weed through the state’s legislature. This new law also enables MMJ patients to grow up to five plants at home. Also, if you have a medical marijuana card, you are exempt from taxes when the adult-use market is in full effect. From the beginning of February 2019, patients who submit their MMJ registry card application online will receive provisional access to a licensed dispensary within 24 hours of completing their application!

Of the five categories, Illinois only performs to a lower standard in terms of Functionality where it received a score of 75. According to the state’s MMJ patients, getting ID cards quickly is still an issue despite the new legislation. There are also concerns over the high price of weed products.

Honorable Mentions

honorable mentions

Oregon ranks #2 with a score of 91.49%. The state’s medical program has improved annually. In 2015 and 2016, the ASA awarded a ‘B’ grade to Oregon, which was boosted to a B+ in 2017 and is now an ‘A’ grade in 2018-19. Unlike Illinois, Oregon scores at least 80 in all five categories.

There were over 28,000 registered MMJ patients in the state as of April 2019. Last year, the state introduced new rules regarding the disposal of packaging and use of pesticides. For a brief period in August 2018, limits on what you could purchase were relaxed, so it was possible to buy up to 24 ounces at once!

This year, a bill to prevent landlords from denying houses to prospective tenants with MMJ cards was signed into law. Landlords are also not allowed to refuse an application if a prospective tenant has a low-level marijuana conviction. Despite a surplus of weed, Oregon residents continue to worry about the high cost of cannabis.

California narrowly missed out on an ‘A’ grade with a stellar score of 89.75%, as did Hawaii with a score of 89.64%. In many ways, the Golden State is faring well because its program has close to a million patients! It isn’t easy to keep track because the state doesn’t make the process of registering for a card mandatory.

While it is extremely easy to qualify for an MMJ card in a state where recreational cannabis is also available, high taxes are making pot unaffordable to medical patients in real need of treatment. This year, California made co-operatives illegal, which dealt a severe blow to low-income patients.

Worryingly, in July 2018, 20% of samples sent to labs had contamination from chemicals, bacteria, or pesticides, or else they were inaccurately labeled. On the plus side, a bill was signed in 2018 that prevented marijuana businesses from sharing the information of customers for commercial purposes. Governor Brown also signed a bill that reduced prior cannabis convictions.

What About the Worst Medical Marijuana Program?

West Virginia legalized medical marijuana via Senate Bill 386 in 2017, but has managed to become the first state with a proper medical cannabis program to achieve a ‘Fail’ grade in an ASA report! With a dismal score of 58.83%, West Virginia ranks dead last amongst all states where medical weed is legal!

The slow rollout of the program is a source of immense frustration to residents. According to the state’s lawmakers, it is down to lack of banking access. The state’s Medical Cannabis board recommended making smokable forms of the herb available in February 2018. Fast forward to March 2019, and a medical marijuana banking bill was signed into law.

Overall, medical marijuana should have been available in West Virginia by July 2019, but this has not happened. It could take another 2-3 years after a banking vendor is put in place before sales begin! It is a disgraceful state of affairs, especially since the state is the nation’s leader in opioid deaths with almost 50 per 100,000 population. Incidentally, every state with a CBD-only or low-THC program failed according to the ASA.

Idaho and South Dakota lead the Hall of Shame with a score of 1% apiece, although Nebraska isn’t even included in the report.

The Crippling Cost of Cannabis

The ASA surveyed a group of patients and found that almost 90% believed marijuana products were too expensive. While the sample size was small, at 500 patients, it was remarkable to discover that almost all of them believe the cost of weed is too high. In states such as California, there is an array of taxes that massively increase the price of medicinal and recreational cannabis. Sadly, the high cost means the black market continues to thrive as it provides far cheaper products.

As marijuana remains federally legal, you can forget about being covered by your health insurance. There isn’t a single health insurer in the country that covers the use of medical marijuana. All of these companies cover deadly opioids, which result in the deaths of 130 people in the United States every single day.

Final Thoughts on Medical Marijuana Programs

Without the help of the ASA, it would be exceedingly difficult to determine the best and worst states for medical marijuana. The hard work of the group has directly resulted in significant improvements in several states. For example, the 2017 ASA report said that Arizona needed to develop product safety regulations and enforce lab testing standards.

The state subsequently passed SB1494, which improved testing standards for medical weed and associated products. The bill also reduced patient fees. As a result, the ASA improved Arizona’s grade to a ‘B+’ from a ‘C’.

The ASA continues to fight the good fight and includes a lengthy list of recommendations at the end of each report. This time around, it believes that Insurance Coverage is essential to combat the high cost of marijuana. The ASA is also adamant that more states need to offer a trade-in option where patients can swap their opioids for cannabis.

It is heartening to learn that two states have attained an ‘A’ grade with two more coming within 1% of joining them. Overall, 14 states received 85%+, which suggests we could have a few more ‘A’ grades in 2020. For now, however, Illinois leads the way, closely followed by Oregon.

For more on how to get medical cannabis in your state, check out our article: Get Your Marijuana Card and Become a Qualified MMJ Patient