House Bill 46: Improves Compassionate Use Program

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House Bill 46 aims to improve the Texas Compassionate Use Program (TCUP). The bill defines the allowable amount of THC in terms of milligrams (rather than % by weight) 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 11 dispensing licenses, which must be located strategically within Texas' 11 public health regions. The bill also allows dispensing organizations to open approved satellite locations.  

Status: HB 46 was heard by the Public Health Committee on Monday, April 14, 2025.

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!

Patient Impact

• Prescription Limits: Patients would be prescribed a 90-day supply of medication. Total THC would be limited to 20mg per dose and 1.2g per package.
• Product Availability: Allows the use of cannabis patches, lotions, and suppositories as well as approved inhalers, nebulizers, and vaping devices.

Policy Recommendation: While we support this bill and its efforts to improve TCUP, the proposal should also include additional qualifying conditions so more patients have access to the program. Ideally, doctors would decide if a patient can benefit from medical cannabis. 

At minimum, patients suffering from severe pain should have the opportunity to use cannabis as an alternative to dangerous and addictive opioids. (Pain has now been added to the latest version of HB 46!)

Business Impact

• Satellite Locations: With approval from DPS, licensed dispensing organizations could open one or more satellite locations in addition to their primary location. 
• Limited Licenses: DPS would be required to issue 11 licenses. 
• Regional Access: New or renewed licenses would be issued strategically to ensure adequate patient access in each of Texas’ 11 public health regions.
• 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. 

If passed, HB 46 would go into effect on September 1, 2025 and all necessary rules must be adopted by October 1, 2025. 

Policy Recommendations:  In the spirit of free enterprise and innovation, we recommend removing the statutory cap on the number of licenses. Let the Department of Public Safety determine the appropriate number of licenses based on patient need, population, and infrastructure.

Additionally, licensing fees should be reconsidered. The current $488,000 initial fee and $315,000 renewal fee every two years create a barrier to entry and limit competition—especially for small businesses.