In Trenton, Orange, and Teaneck, New Jersey, medical cannabis is now recognized as a medical expense for public employees.
This is the first instance of a non-cannabis industry employer providing programs like these.
Qualified employees will benefit from discounts on cannabis purchases at participating dispensaries and can access telehealth support through collaborations with Bennabis Health and other healthcare providers.
This could serve as a model for expanding health benefits for Medicaid-eligible medical cannabis patients with disabilities in Washington State.
Advocates across the country highlight that medical patients' needs frequently differ greatly from those of recreational users. In Washington, as in other states, patients need reliable access to particular strains and product types that address their conditions—an essential requirement that can sometimes be eclipsed by the profit-focused recreational market.
According to the Statista Research Department, as of February 5, 2016, medical cannabis patients typically spend between 50 and 150 U.S. dollars monthly on cannabis products. The 35-44 age group had the highest proportion of individuals spending over 150 U.S. dollars each month.
For example, cannabis use during cancer treatment may contribute to significant out-of-pocket costs, with men and younger patients more likely to pay higher costs.
In numerous states where medical cannabis is acknowledged as a legitimate form of medication, the law does not mandate that workers’ compensation coverage should include reimbursement for medical cannabis. Notably, only six states have determined that workers’ compensation must cover the costs of medical cannabis treatment for injured workers, provided the treatment is deemed "reasonable and necessary." It is important to note that states have reached these conclusions through different methods and legal theories.
For instance, courts in New Mexico and New Jersey ruled that employers must compensate employees for using medical cannabis to treat a workplace injury. Conversely, in New York and California, this decision was made by their Workers’ Compensation Commissions rather than through court rulings.
Additionally, courts in two states, Louisiana and New Hampshire, permit the reimbursement of medical cannabis medication but do not mandate it. In contrast, thirteen states explicitly state that medical cannabis is not eligible for reimbursement under workers' compensation.
In Washington, disabled individuals must reduce their income to qualify for Medicaid benefits by spending down to the program's income limits. The spend-down amount is the gap between your income and the Medicaid threshold. To qualify, you need to provide medical bills that match or exceed your monthly spend-down requirement. Examples of eligible medical claims include:
Medicaid eligibility is determined by a means test, which bases benefits on monthly income. In Washington, the income limit is $1,732 for one person, $2,351 for two people, $29,974 for three people, $36,156 for four people, and $42,339 for five people. The spend down amount is calculated by getting credit for medical-related expenses and deducting them from your income above the income limit. This is the amount you need to "spend" on medical expenses before DSHS begins to cover them.
The formula is: Countable Income - Income Allowance = Excess Income x Base Period = Spenddown.
Permissible expense examples:
• Medically necessary improvements to the home to accommodate a disabled person
• Medical supplies (e.g. syringes, adult diapers, etc.) and drugs, including OTC drugs prescribed by an M.D., D.O. or A.R.N.P.
• Medical transportation by other means (e.g. bus, taxicab/rideshare, etc.) at the actual fare or fee. May include parking fees
• Medical transportation by personal vehicle at the current state reimbursement rate
Among unallowable expenses are:
• OTC drugs and medications not prescribed, including medical cannabis, even if it is prescribed.
• In-home cooking/cleaning services
• Massage Therapy, unless prescribed (must be provided by licensed practitioner)
The New Jersey initiative prioritizes patient needs, emphasizing their importance in discussions about cannabis accessibility.
The organization intends to collaborate with more municipalities in New Jersey and extend its reach to other states where medical marijuana is permitted.
Bennabis Health seeks to remove the stigma and logistical challenges that have historically impeded medical cannabis use by developing a healthcare model that incorporates cannabis into standard insurance plans.
This model is crucial for all medical cannabis patients, especially those who are disabled and qualify for Medicaid. Washington State should facilitate access to these benefits, and on a national level, Medicaid should incorporate these costs into their spend-down calculations.
References
Statista Research Department
The Network For Public Health Law
Bennabis Health
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