6/21: Gov. Abbott has signed HB 46 into law, expanding and improving the Compassionate Use Program

Just one day before the deadline, Gov. Greg Abbott signed House Bill 46 into law, ensuring a significant improvement and expansion of the Compassionate Use Program (TCUP). This big change makes Texas the 40th state to establish a comprehensive medical cannabis program!

The bill adds several qualifying conditions and allows the use of cannabis patches, lotions, and suppositories as well as approved inhalers, nebulizers, and vaping devices. 

To ensure adequate patient access, HB 46 instructs the Department of Public Safety (DPS) to issue 15 dispensing licenses, which must be located strategically within Texas' public health regions. The bill also allows dispensing organizations to open approved satellite locations. Find the full bill overview below.

While there are still shortcomings, including outrageous licensing fees and a real need for regulatory accountability, many more patients now have access to the program with more product choice. 

• Prescriptions: Patients would be certified for 1 year, with (4) 90-day supply refills of medication. Prescriptions would be monitored by the Texas Medical Board.
• Product Availability: Allows the use of cannabis patches, lotions, and suppositories as well as approved inhalers, nebulizers, and vaping devices. Total THC is limited to 10mg/dose and 1 gram of THC per package. To be most effective, inhalable products (vape/inhalers) are not limited to 1% THC. Limits cannabinoids in products to natural phytocannabinoids.
• Qualifying Conditions: Grants access to program for patients with chronic pain, traumatic brain injury, Crohn's disease, and any terminal illness or condition for which a patient is receiving hospice or palliative care. 

• Limited Licenses: Department of Public Safety (DPS) would be required to issue 15 total licenses. 
• Regional Access: New or renewed licenses would be issued strategically to ensure adequate patient access in each of Texas’  public health regions.
• Satellite Locations: With approval from DPS, licensed dispensing organizations could open one or more satellite locations in addition to their primary location.  Requires DPS to establish rules about the design and security of satellite locations.
• Active Licenses: Dispensing organizations would be required to begin operations within 24 months of receiving their license and must maintain production in order to retain their license. All new dispensaries must be 1,000 ft. from any school.
• Licensing Process: DPS will issue nine additional licenses by Dec. 1, 2025 and three additional licenses must be issued by April 1, 2026. 
• Pulmonary Inhalation: The Department of State Health Services (DSHS) commissioner will establish rules relating to products/devices for the purpose of pulmonary inhalation (inhaler, vape, nebulizer).
• Prescription Monitoring: The Texas Medical Board (TMB) will establish rules and procedures for oversight and monitoring of physicians to prevent over prescribing.

HB 46 goes into effect on September 1, 2025 and all necessary DPS and DSHS  rules must be adopted by October 1, 2025. TMB must adopt rules for monitoring prescriptions as soon as reasonably possible.

Last night (6/1) was a big deadline for the House and Senate to approved Rep. Ken King's HB 46. With bipartisan support, the bill was approved in time and will significantly expand the Texas Compassionate Use Program. This is great news for the MANY Texas patients who will now qualify for legal access to medical cannabis!

House Bill 46 adds the following qualifying conditions: chronic pain, traumatic brain injury, Crohn's disease, and any terminal illness or condition for which a patient is receiving hospice or palliative care. The new law allows the use of cannabis patches, lotions, and suppositories as well as approved inhalers, nebulizers, and vaping devices. Prescriptions will be valid for one year, with (4) 90-day supply refills. Products may contain up to 1% total THC and no more than 10mg/serving and 1gram/package.

To ensure adequate patient access, HB 46 instructs the Department of Public Safety (DPS) to issue 15 dispensing licenses, which must be located strategically within Texas' public health regions. The bill also allows dispensing organizations to open approved satellite locations.  

If approved by the governor, HB 46 would go into effect on September 1, 2025 and all necessary rules must be adopted by October 1, 2025. Nine new business must be licensed by Dec. 1, 2025 and an additional 3 new licenses must be issued by April 1, 2026.

Chairman King’s excellent medical cannabis bill - HB 46 - passed the House with overwhelming bipartisan support. Unfortunately, when the bill moved to the Senate, it was weakened by Sen. Perry, who stripped away key provisions — including many qualifying medical conditions and critical business licensing opportunities.

But Chairman King isn’t backing down! When HB 46 returned to the House yesterday (5/30), he rejected the watered-down version. Now, House and Senate leaders have formed a conference committee to reconcile the differences. (See a side-by-side comparison above.)

House Appointees: Rep. Ken King (Chair), Rep. Giovanni Capriglione, Rep. Katrina Pierson, Rep. Tony Tinderholt, and Rep. Chris Turner.

Senate Appointees: Sen. Charles Perry (Chair), Sen. Paul Bettencourt, Sen. Bryan Hughes, Sen. José Menéndez, and Sen. Tan Parker.

Chairman King is standing firm — fighting for a stronger, more inclusive Compassionate Use Program for Texas patients!

House Bill 46 aims to improve the Texas Compassionate Use Program (TCUP) and has evolved at nearly every stage of the legislative process. After passing the House as a great bill to improve and expand TCUP, the bill was amended by the Senate State Affairs Committee to be far more restrictive. 

Late on Tuesday, May 27, the Texas Senate amended and passed HB 46. Several amendments were offered by the bill sponsor, Sen. Charles Perry, to further expand the program and provide guidance for the licensure process.  A full breakdown of the bill as amended in the Senate can be found here.

Status: 05/27/2025 Passed by the Senate Unanimously

Next Step: Final House Approval (or Conference Committee)

ACTION: Send your legislators a thank you note for their support of medical cannabis!

HB 46 passed unanimously and now heads to the House for final consideration. The House can concur with Senate amendments and send the bill to Governor Abbott or they can contest the amendments and send the bill to conference committee. 

Here's a look at the Senate amendments:

• Any TCUP business owners with more than 10% stake in the company are required to submit fingerprints for a background check and register with the Department of Public Safety (DPS). (This is controversial.)
• DPS will issue nine additional licenses. The first three licenses must be issued by Oct. 1, 2025 and they must be issued to companies from the pool of applicants from 2023. An additional six licenses must be issued by April 1, 2025. Preference will be given to Texas companies when possible.
• Satellite locations are no longer required in each public health region before a second location can be opened in any single region.
• Patients may purchase up to a 90-day supply with three refills.
• Additional Qualifying Conditions: Chronic pain or a terminal condition while in hospice care. Chronic (vs acute) pain defined by the Texas Medical Board and may require patients to use opioids for 90-days. Sen. Perry denied this during the debate, but his amendment includes this compulsory language. 
• Rules must be proposed by Oct. 1, 2025.

On Friday, May 23, the Senate State Affairs Committee adopted an amended version of HB 46 with significant changes. Listen to the meeting here.

Most concerning: the House-approved list of qualifying conditions was stripped down to only include terminal patients in hospice care. The bill also strips patient protections and privacy. 

The committee substitute for HB 46 cuts access for patients with chronic pain, glaucoma, traumatic brain injury, spinal neuropathy, Crohn's disease or other inflammatory bowel disease, and degenerative disc disease. The only additional patients who would qualify to participate in TCUP are those with a terminal illness or condition and who are actively receiving hospice care. The substitute also removes language that would have granted DSHS authority to add new qualifying conditions. 

A full breakdown of the bill as amended in committee can be found here. Sen. Perry has indicated that he'll be offering further amendments on the floor. 

LATEST NEWS: Late on May 25, Rep. Oliverson announced that he and Lt. Gov Patrick have come to an agreement on the final bill.

Monday, May 19, the Senate State Affairs Committee hosted a very quick hearing for HB 46, Chairman King's medical cannabis bill.

"There will be a committee substitute, but we haven't gotten it back from legislative council yet." - Sen. Perry

Sen. Perry did acknowledge that cannabis is medicine and patients should have access to it. He also implied that the viability of this bill is dependent upon the success of SB 3 banning "intoxicating" hemp.  We knew that was the game they're playing, but to hear it so clearly this morning really puts into perspective the fact that they are holding medicine hostage in order to fulfill their goals of hemp THC prohibition.

The committee will take up the bill again when their revised draft is ready. Since they took testimony at today's hearing, they will not be required to hear from people again. 

With a bipartisan super-majority vote of 122-21, the Texas House of Representatives has passed Chairman King's HB 46 to expand and improve patient access to medical cannabis. 

Next Step: HB 46 was quickly referred to the Senate State Affairs Committee, which will host a public hearing. Date: TBD.

There were a few changes made through floor amendments, including Rep. Oliverson's prescription monitoring and Chairman King's own amendment improving patient access. 

Chairman King's amendment removed the 1 gram THC limit per package, changed the requirement from 11 to 15 business licenses total, removed the 1% cap on inhalation products, and removed the restriction on "naturally occurring chemical substance from the cannabis plant that is not a phytocannabinoid."

On Monday, April 14, the House Public Health Committee hosted a hearing on Chairman Ken King's HB 46. Witnesses waited more than 13 hours to testify in support of this bill, which would improve and expand the Texas Compassionate Use Program. Testifying witnesses included patients, caregivers, business operators, and medical professionals. 

Chairman King's committee substitute for HB 46 adds chronic pain as a qualifying condition. This is great news! This important change allows Texas patients to use cannabis as an alternative to opioids.

Chairman King closed out the hearing with the following:   

"One thing that's not talked about in here is hospice care. I'm gonna tell you right now, y'all have heard me a lot over the years talk about my mother. I watched her die over 10 1/2 weeks in hospice. And if I had it to do over again, instead of giving her the poison they were shoving down her, I would have gone to Colorado and bought a joint. That's just me. I don't use it myself, but I hope for your favorable consideration on this bill. And if you have suggestions, I'm open to them." (Watch this moment.)

There may be further amendments to the bill before it's passed out of committee. Stay tuned for updates!