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Insurance companies can't be forced to reimburse Massachusetts patients for medical marijuana use, at least not until the federal government legalizes it, court rules

The state's highest court today rejected an injured worker's request that the company that paid him worker's comp pay for his purchases of the medical marijuana that eased his pain following complications from surgery for a work-related injury.

Although medical marijuana is legal in Massachusetts, the referendum that made it so in 2012 contains a provision that exempts insurers from having to pay for it, because its use remains illegal under federal law.

Until the federal government formally legalizes medical marijuana, that provision will remain in effect, the Supreme Judicial Court ruled.

At issue were claims submitted by Daniel Wright, who injured his knee in 2010 while stepping off a stair during his work as a cable installer in western Massachusetts. He recovered, got a new job and then re-injured his knee again in 2012. This time, he suffered complications from surgery that left him in frequent pain. In 2013, he applied for and received a medical-marijuana prescription. According to the court's summary:

Wright's use of medical marijuana reduces his pain, increases his mobility, improves his sleep, and reduces his anxiety and anger. Wright has also been able to eliminate the use of any opioids as a result of his medical marijuana use.

But the company that provided his worker's comp payments rejected his requests for reimbursement for his $24,267.86 in medial-marijuana purchases in 2016 and 2017. The Workers' Compensation Trust Fund agreed with the company, citing the risk it would be taking under federal law.

And in its ruling today, the SJC agreed, saying insurance companies should not be put in the position of possibly facing federal law-enforcement actions:

If insurers were required to make such payments, the size and scope of the legalization of medical marijuana would be substantially expanded, raising concerns about Federal enforcement and preemption. First, unlike the patients and doctors covered by the act, insurance companies would not be participating in the patient's use of a federally proscribed substance voluntarily. It is one thing to voluntarily assume a risk of Federal prosecution; it is another to involuntarily have such a risk imposed upon you.

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Comments

does the fed have to do with this? Insurers have to be licensed in the states in which they operate, do they not? this is under state jurisdiction is it not?

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The issue is the exchange of money and the unwillingness of insurance companies to take the risk that that might expose them to federal prosecution. Since there's an escape clause for that reason in the 2012 referendum, the court said it's a valid concern. Just because federal prosecutors, even now, haven't spent a lot of time on marijuana issues, doesn't mean they wouldn't if the stakes/amounts are high enough - and paying people's worker's comp claims might qualify for that.

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Because the feds control interstate commerce. Everything falls under interstate commerce, even things that don't involve interstate commerce

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Anyone willing to spend $200-$300 can get a medical card. That’s not a large upfront investment if you’re a full time stoner.

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You'd be surprised how many people scoff at that cost. But with more 'adult use' only places opening, they are starting to have a point as the prices are almost the same between the adult use and medi dispensaries.

I used to tell people its worth it because outside of the ability to go into a store and buy it at a whim (vs a texting/meetup ordeal), many places give you almost the entire fee back to you in free bees. NETA gives you 3 50 dollar credits every year. Restrictions apply but still it equals out the application and doctors fees

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Pay less tax if none.

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Some of us suffer from certain conditions that make obtaining very specific strains EXTREMELY important.

For health reasons these days I'm in it for the relief, not the good times. And although it's kinda boring, not being nauseous all day is far more important than laughing my ass off watching mystery science theater episodes I've already seen 400 times.

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Is $1000 per month a lot for MMJ?

I have no sense of scale here.

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Yes it is a lot. But not completely unrealistic with the current costs because there don’t seem to be bulk discounts.

Cost in Massachusetts for MMJ and Recreational has not come down to a reasonable amount on par with other states such as CA and CO.

$1000 on the black market will get me a top quality QP, and this amount lasts me about 3-4 months smoking small quantities regularly frequently throughout the day. Going to a dispensary this would be at least double, probably more.

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State limits you to 10oz over 60 days. So we'll say 5oz for a month. Sans any discounts your place offers you, its roughly 350/oz or so yeah its about on target for the run of the mill smoker.

Of course it varies.. some people don't smoke alot. some do. Also realize that MMJ products, not flower, often cost more. SO if you're a vape or edible person, you're paying far more than you were if you were for the "flower equivalent".

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If you’re smoking over a zip a week, you’ve got a problem.

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you’ve got a problem.

Do you not understand the "medical" part of "medical marijuana"? Of course they've got a problem.

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So, what is the Massachusetts Congressional Delegation doing to right this wrong?

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There are a lot of catch-22s with the legalization of marijuana at the state level while it remains illegal at the federal level.

For example, landlords and condo associations might not be able to prohibit marijuana use, but their insurance policies typically exclude claims where marijuana is involved.

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