After months of political wrangling and high-stakes negotiations, Texas lawmakers passed a significant expansion of the Texas Compassionate Use Program (TCUP) late Tuesday night, marking what could be the largest reform to the state’s medical cannabis system since its inception.
The final push came as part of a committee substitute to House Bill 46, which was brought before the Senate after legislative leaders in both chambers reached a last-minute compromise. The revised bill, backed by Lt. Gov. Dan Patrick and key House and Senate members, includes new qualifying conditions, expanded licensing for dispensaries, and increased patient access across Texas.
From Resistance to Reform
The road to the bill’s passage was far from smooth. Just last week, tensions flared when a leaked draft of the TCUP expansion bill omitted previously promised additions, including coverage for chronic pain and traumatic brain injury—two conditions advocates had long pushed to include.
Rep. Tom Oliverson (R-Cypress), a key sponsor, publicly criticized the draft, calling it a betrayal of commitments made to patients and lawmakers. Patrick responded quickly, affirming that he and Oliverson had reached a new agreement to restore those conditions and strengthen the bill overall.
“We look forward to passing this bill for our veterans and those who suffer from chronic pain,” Patrick said in a statement following the renewed negotiations.
What the New Bill Does
When HB 46 reached the Senate floor Tuesday night, Sen. Charles Perry (R-Lubbock) introduced a series of amendments that lawmakers described as a "significant expansion" of the medical cannabis program. Among the key reforms:
Expanded Qualifying Conditions: Chronic pain, traumatic brain injury, hospice care, and terminal illness are now included.
More Access Points: The number of licensed dispensary locations will increase to 12, with three new licenses prioritized for current applicants.
Geographic Equity: The Texas Department of Public Safety (DPS) is directed to prioritize dispensary placements based on underserved areas, reducing travel burdens for rural patients.
Operational Improvements: Satellite dispensaries will be fast-tracked through a 90-day authorization process and must be equipped with secure overnight storage.
Product and Prescription Changes: Metered-dose inhalation devices are now allowed, and doctors can prescribe for flexible durations ranging from 1 to 90 days.
Regulatory Oversight: Dispensary owners must undergo fingerprinting, and Texas-based applicants will receive preference.
A Rare Bipartisan Moment
During the bill’s final debate, Sen. Jose Menendez (D-San Antonio) applauded the bipartisan effort that ultimately brought the legislation across the finish line, noting ideological divides were put aside for the benefit of Texans in need.
“I know you don't want Texas to ever be California, and it won't,” Menendez said, addressing Lt. Gov. Patrick. “Because we're Texans. And what we're trying to do is help people live without pain.”
Patrick, once seen as a roadblock to expanded cannabis access, voiced support for the final version, emphasizing the need to eliminate illegal THC products and regulate the industry more effectively.
“We've wiped them out. And now we're building the biggest compassionate use program probably launching in the country,” Patrick said. “It really is a launch.”
He noted that Texas currently has only one operating medical cannabis provider, which saw a dramatic 90% drop in business due to competition from unregulated products.
What’s Next
The amended HB 46 now returns to the House for a final vote to approve the Senate changes. If the House concurs, the bill will be sent to Gov. Greg Abbott’s desk for signature. With bipartisan momentum and widespread public support, the measure is expected to clear the final hurdle.
For patients, veterans, and advocates who have long fought for a more inclusive and accessible medical cannabis system in Texas, Tuesday night’s vote was a long-awaited breakthrough.
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