What Obamacare Won't Change: No Coverage for Medicinal Marijuana
Two sets of poll results released last week suggest that both doctors and the public have come around on the question of cannabis use. But the resurgent Affordable Care Act, which recently exceeded its original target for insurance exchange enrollments, offers no relief to patients who struggle to afford the cost of marijuana prescribed by their physicians. And the drug's status, in the eyes of both the federal government and the insurance industry, appears to be caught in a catch-22 of legality and established effectiveness.
On the question of the drug's safety, Pew reports that, "by wide margins, the public views marijuana as less harmful than alcohol, both to personal health and to society more generally." That margin overall is almost five-to-one, and includes majorities of more than two-to-one in every demographic category. Regarding legality, Pew detects "a major shift in attitudes": "As recently as four years ago, about half (52%) said they thought the use of marijuana should not be legal; 41% said marijuana use should be legal. Today those numbers are roughly reversed 54% favor marijuana legalization while 42% are opposed." Medicinal use of marijuana enjoys broad approval, with majorities saying it should be legal in almost every demographic and partisan group.
Meanwhile, an unscientific survey conducted by WebMD set out to test doctors' attitudes toward the drug and found that a majority say "medical marijuana should be legalized nationally and that it can deliver real benefits to patients." Of 1,544 physicians surveyed, 69% said that cannabis "can help with certain treatments and conditions," and 56% supported "making it legal nationwide." Support for medicinal marijuana varied by field, but even among the specialists who expressed the lowest level of approval -- rheumatologists -- a majority favored legalization (54%). Not surprisingly, since marijuana is often used to treat cancer pain and the side effects of chemotherapy, oncologists and hematologists expressed the highest level of support for the drug (82%).
Though medicinal marijuana is legal in 20 states and the District of Columbia , prohibition is still in force at the federal level. Under the Controlled Substances Act of 1970, marijuana is classified as a Schedule I drug, which means that in the government's view it cannot be used safely even under medical supervision. (Cocaine and morphine, by contrast, are Schedule II controlled substances, out of deference to their "currently accepted medical use in treatment.") So according to Uncle Sam, no prescriptions for cannabis can legally be written. Even investigating the drug's medical value is difficult: research-grade marijuana is controlled by the National Institute on Drug Abuse, which is interested in studying addictiveness, not therapeutic potential.
The government's position is a boon for health insurance companies, which of course don't want to pay for anything they don't have to. Obamacare has compelled insurers to make some changes to their penny-pinching ways: they can no longer deny coverage for people with preexisting conditions (or charge them more), and lifetime or annual dollar limits on essential health benefits are now prohibited. But the ACA doesn't solve the problem of companies declining to cover certain treatments prescribed by physicians.