Key Takeaways
- The deadline: Federal “total THC” standard changes are scheduled to take effect on November 11, 2026.
- The technical shift: New statutory definitions in H.R. 5371 will close industrial hemp loopholes but also will remove many non-intoxicating, full-spectrum medicines from the market.
- At-risk groups: Veterans, seniors, and patients with rare diseases who rely on the hemp marketplace due to high costs in state-regulated medical markets are most vulnerable.
- The call to action: ASA is urging governors to develop state-level “transition strategies” rather than relying on federal rescheduling, which cannot override statutory limits.
WASHINGTON — State leaders must prepare for a significant disruption in cannabinoid medicine, according to a new report from Americans for Safe Access (ASA). The report, Protecting Patient Access: A Compassionate Response to Changing Federal Hemp Laws, warns new federal standards set to become effective in November 2026 could inadvertently strip millions of patients of access to full-spectrum hemp products.
In the absence of a comprehensive national medical cannabis framework, the fallout once again will land on state leaders, the organization suggested.
Legislative fallout: closing loopholes, cutting access
The report, which functions as a policy briefing for governors, state policy makers, and regulators was created in response to language added to H.R. 5371, the Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act of 2026. The legislation establishes statutory definitions for “industrial hemp” and “hemp-derived cannabinoid products” and imposes a new “total THC” standard. Together, when they go into effect November 11, 2026, these clarifications will close the “loophole” that allowed unregulated intoxicating products to proliferate, but they will also remove most full-spectrum cannabinoid products from lawful commerce.
“Americans for Safe Access has prepared this briefing to help state leaders navigate this moment with clarity, accuracy, and compassion,” Executive Director Steph Sherer said. “Effective responses must account not only for patients currently dependent on the unregulated hemp marketplace, but also for the conditions that made it their only viable option. Barriers such as cost, access deserts, and limited product availability, driven by competition for shelf space in adult-use markets, left patients with few options.”
Vulnerable populations at risk
The briefing highlights who is most at risk. Seniors, veterans, people with disabilities, cancer patients, and children with rare diseases have relied on full-spectrum cannabinoid medicines from the hemp marketplace for years. Many turned to hemp only after being pushed out of state medical cannabis programs by cost, geography, clinical barriers, or shrinking product options in adult-use markets.
The limits of federal executive action
The report dispels the misconception that President Trump’s executive order or cannabis rescheduling will fix these access gaps. Executive action cannot override statutory limits, and rescheduling alone does not legalize medical cannabis or restore patient rights. Sherer said without state-level transition strategies, millions of patients face losing medicines they use to manage chronic pain, epilepsy, PTSD, cancer symptoms, and other serious conditions when the new federal definitions take effect.
For more than thirty years, states served as laboratories of democracy for medical cannabis. They built patient registries, safety standards, testing regimes, labeling systems, and clinical pathways, generating the real-world evidence that finally compelled the Department of Health and Human Services and the Food and Drug Administration to recognize cannabis as having “currently accepted medical use.”
These state-based experiments proved what federal policy refused to test, Scherer said.
“Silence from state leaders today will mean suffering for patients tomorrow,” she added.
