On May 12, Texas House lawmakers voted 118-16 to expand the state’s low-THC medical cannabis program through House Bill 46, sponsored by Rep. Ken King, R-Canadian. This legislation aims to increase access to medical cannabis by broadening the range of qualifying conditions, allowing honorably discharged veterans to use medical cannabis for any health issue, and increasing the number of licensed dispensaries across the state.
Since its inception in 2015, the Texas Compassionate Use Program has limited access to cannabis products containing no more than 0.5% THC for patients with intractable epilepsy. Subsequent amendments in 2019 and 2021 raised the THC limit to 1% and expanded qualifying conditions to nine categories. However, Texas still lags behind 41 states that have legalized some form of medical cannabis, with many allowing higher THC products and broader access for chronic pain patients.
Rep. King emphasized the need for improved access, stating, “Texans still struggle to get access to the medicine they’re legally allowed to receive.” As of March 2025, the Texas Department of Public Safety (DPS) reported 110,026 unique patients in its compassionate use registry, but only 45% had filled a prescription in the past year. One major obstacle to participation is the limited number of licensed dispensing organizations, with only three currently operating across Texas’s 270,000 square miles.
House Bill 46 mandates the DPS to issue 11 vertically integrated licenses for dispensing organizations to ensure patient access in each public health region. Currently, most dispensing organizations are concentrated in Austin and Bastrop, making it difficult for patients in other areas to obtain medications.
The DPS had previously opened an application window in early 2023 for new dispensaries, receiving 132 submissions, but did not set a deadline for approvals. Under the new bill, licensed cannabis businesses could establish satellite locations to store low-THC products securely for distribution, addressing challenges faced during events like the February 2021 winter storm that disrupted deliveries.
The proposed legislation would also broaden the list of qualifying conditions for medical cannabis, allowing recommendations for patients suffering from: 1. Chronic pain typically treated with opioids 2. Glaucoma 3. Traumatic brain injury 4. Spinal neuropathy 5. Crohn’s disease or inflammatory bowel disease 6. Degenerative disc disease 7. Terminal illnesses or conditions requiring hospice or palliative care 8. Any medical condition designated by the Department of State Health Services (DSHS).
Currently, the program is limited to conditions such as epilepsy, multiple sclerosis, and PTSD. The bill allows physicians to petition the DSHS to add further qualifying conditions.
The legislation also revises the definition of “low-THC cannabis” to products containing less than 1% THC by weight per dosage unit. While smoking cannabis remains prohibited, the bill allows for alternative methods of administration, including vaporization, absorption through patches or lotions, and suppositories. Physicians will have the discretion to prescribe up to a 90-day supply with four refills, removing the previous 1.2-gram limit on product packages.
Rep. Penny Morales Shaw, D-Houston, who co-sponsored the bill, shared her concerns about current access issues. Many Texans report relying on more harmful medications like opioids due to insufficient access to low-THC cannabis. “This is a really important bill for many of our constituents who have been asking for better access to less harmful medicine,” she stated.
Although a previous proposal in April 2023 to increase the THC limit to 5% stalled in the Senate, House Bill 46 must pass a third reading in the House before moving to the Senate for consideration. This expansion represents a significant step towards aligning Texas’s medical cannabis program with the needs of patients and simplifying access across the state.
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