Americans for Safe Access (ASA) is a Washington, D.C.-based nonprofit spearheading the effort to ensure safe and legal access to cannabis for therapeutic use and research. In a new ASA State of the States annual report card on the efficacy of each state’s medical cannabis laws and programs, the commonwealth did well in patient rights and civil protections, but not so much with access to medicine. Executive Director Debbie Churgai says they’ve been working on it for 20 years, always focused on the patient. “Our mission is to ensure safe and legal access to medical cannabis. Educating lawmakers, educating medical professionals, educating the public, ending the stigma, getting more research out—these are all of our missions here." 

Churgai says, “There was plenty of room for improvement in every state. States were graded on patient rights, parental rights and protections, employment protections for patients, and pediatric patients and their access to medicine.” They were also graded on patient access, affordability of the products and other costs, and product safety. “Taxes are a huge issue. Sometimes, patients are paying more in taxes than they are for the actual medicine. We totally advocate for no taxes for medical patients," she says. 

Pennsylvania's grade was C+, which may seem average, but Churgai notes, “We had to grade on a curve. Every state's score was so low, every state would have received a D.” Maine was awarded the only B, Illinois the only B-. Pennsylvania's C+ was the third-highest score, the same as cannabis powerhouses like Colorado and California. “Pennsylvania did okay compared to the other states,” she says. 

Churgai describes how the grades were assigned. “It’s a very, very lengthy process. We started many, many months ago. We added two new sections, one on affordability and one on social health and equity, which is also a big, hot topic these days.” This includes ensuring there is no list of qualifying conditions. “We believe that a doctor should be able to recommend for anything that they see fit,” she says. 

Pennsylvania's program got off to a rocky start after dispensary doors opened in February 2018. The biggest problem was the unpredicted popularity of cannabis as medicine. Growers that planned on 50,000 patients in the first year were stunned when more than 100,000 people signed up. According to the report, today Pennsylvania has 384,254 registered patients, one of only five states with more than 300,000, which means 2.68 percent of the total population has a card. Access remains a problem, with a person-to-retail-outlet ratio of 2,403. Churgai says, “In Oregon, it's about 50 patients per dispensary.” 

According to Churgai, “Pennsylvania did well on patient rights and civil protections, with an 80 out of 100 score, which is pretty good compared to a lot of other states. And program functionality, which is about purchase limits, possession limits, telemedicine, caregiver standards, things like that. They did decently in consumer protection and product safety as well, where they got 148 out of 200. Pennsylvania is doing pretty good and they are making improvements. Every year they do try to improve the program. There are some great legislators who are really focusing on this.” 

Pennsylvania's lowest scores are in access to medicine. "The [lack of] retail locations is probably a big one. [Lack of] personal cultivation is huge. That is really important for patients, as it helps with affordability. Pennsylvania lost 20 points for not having reciprocity,” says Churgai, which means permitting patients with cannabis cards issued from other states to purchase in Pennsylvania dispensaries. “Pennsylvania also scored low in health and social equity, especially housing protections. It’s really important for patients to be able to utilize medicine in their own home and feel protected.” 

Nationally, the general trend is for growth. “Not only are there more states with programs, but the number of patients in most states increased over last year, even in states with adult-use programs,” Churgai explains. “Last year’s report had 4.4 million patients, and this year that number is up to 5.1 million patients.” 

Of course, states won’t reach their full potential until after the federal government legalizes cannabis. “What’s going to happen after legalization? What will be the government agencies in charge of all these issues?” Churgai asks. “We have draft legislation that talks about how to protect all the state medical programs by making sure every state has a bare minimum of what they are allowing for patients.” 

We have a plan of what can happen after legalization occurs. We have to have full legalization in order to get health insurance companies to pay for it, get tax breaks, get banks to allow access, things like that. Federal coordination is so important to get patients everything they need and deserve.” 

Find the full report on safeaccessnow.org.