Obamacare Implications of Medical Marijuana in Rhode Island
Tuesday, May 20, 2014
Local advocates for medical marijuana believe Obamacare and other healthcare plans should cover medicinal marijuana as well as pharmaceutical drugs, adding another layer to the hot button debates.
John Simpson, owner the Doggett & Simpson cannabis nutrient company, strongly believes medical marijuana should be covered by health insurance for those who need it.
“If we agree that it confers medical benefits, which I certainly believe strongly that it does, and I think that that’s beyond dispute, I don’t see how you justify denying it insurance coverage.”
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A Cost Effective Solution
Jared Moffat is the Founder and Director of Regulate Rhode Island. He advocates not for or against marijuana, but for marijuana policy reforms he feels will help society as a whole. Moffat strongly believes medical marijuana should be included in healthcare plans.
“I feel that medical marijuana is an appropriate treatment for a lot of people that have bad responses to traditional prescription drugs,” he said. “I feel in the long run, and in the short term as well, it’s going to save on healthcare costs enormously.”
Moffat believes medical marijuana is a cost-effective substitution for prescription opiates that are more addicting and have more detrimental withdrawal effects in addicted patients than medical marijuana.
The problem, Moffat says, is the cost of marijuana compared to the cost of insurance-covered opiates.
“The 30 day supply of Vicodin costs them $5 because insurance covers it, but if they wanted to get an ounce of medical marijuana that’s going to cost them $400-$500,” Moffat said. “I don’t think it makes a lot of sense that we’re letting what is really an appropriate treatment for a lot of folks be underutilized.”
Issues with Smoking as Medicine
Experts against adding medical marijuana to Obamacare argue that smoking is not an acceptable means of medicating an individual.
“I think the chances of getting a smoked joint covered by Obamacare is zip,” said Kevin Sabet, Ph.D. and co-founder of project SAM (Smart Approaches to Marijuana). “Joints cannot be dosed, and smoking is not an accepted medication delivery system.”
The Prescription Debate
For prescription drugs, a doctor writes out a prescription and the patient presents it to the pharmacy in exchange for the medicine. Medical marijuana patients have a recommendation card that is presented to caregivers or dispensaries. Sabet says the processes are not similar enough to warrant insurance coverage for medical marijuana.
“The process for getting a medical recommendation is very different from an actual prescription,” Sabet says. “In the latter, a bona fide physician must write a prescription which gets entered into a database. That prescription must be used at an actual pharmacy and dispensed by a pharmacist. A medical card is received upon a ‘recommendation’ which, depending on the state, does not have to be issued by the patient's actual physician. Also the recommendation is then used at marijuana stores-- most of which are not run by medical personnel.”
Simpson believes the processes are similar enough that a coverage plan could and should be worked out.
“In my opinion they’re certainly close enough, and I don’t see how you can deny it insurance coverage,” said Simpson. “It does carry with it some unique challenges but I don’t think the response to that challenge is to throw up your hands and say ‘well we won’t have it covered then.’”
Moffat believes that with alternative methods available for administering marijuana, namely vaporization and edible/oral products, a compromise of sorts would be feasible. He feels that the “legal limbo” surrounding marijuana (it is federally prohibited but legal in some states) prevents the insurance companies from offering coverage for medical marijuana.
“I understand the insurance companies’ hesitation in taking this on, but I think there is an argument that certainly needs to be made that maybe doctors feel like this is an appropriate treatment, and it is very similar to getting a prescription. From a patients perspective it might as well be a prescription,” Moffat said.
Future Insurance Ramifications
Sabet is willing to consider the medical benefits marijuana provides, but says insurance should never cover smoking and other unapproved medical practices.
“Medicines derived from marijuana and delivered in non-smoked forms may indeed at some point be covered by insurance exchanges, and no one has a problem with that,” said Sabet. “The bottom line is that only approved medicines - derived from marijuana or not - should be covered by insurance.”
Simpson disagrees, arguing that if medical marijuana is the best option available it needs to be covered.
“I think it’s a bit of a litmus test,” said Simpson. “I think if society is sincere and accepting that this does offer significant medical benefits above and beyond what’s even available through industrial pharmaceuticals for some conditions, then I don’t see how you can deny it insurance coverage.”
According to Simpson, a secondary benefit of insurance coverage is that doctors would be more inclined to advise patients on whether or not to use marijuana medicinally.
“I think if it’s being covered by insurance then Doctors would be inclined to take it very seriously as something that is a medical option, but that they shouldn’t recommend more lightly than they would prescribe another drug,” said Simpson.
Related Slideshow: The Highest Marijuana Prices in New England by State
The "crowdsourced" website, The Price of Weed, uses consumer input to show how much an ounce of marijuana costs -- by location.
Below are the rankings of New England states, from lowest price reported for "medium grade" marijuana, to highest, along with the number ("n") submitting data.
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