Texas House lawmakers gave the thumbs up to expanding the state’s low-THC medical cannabis program on May 12 in a move that could increase access and better align policies with patient needs. They voted, 118-16, to pass House Bill 46.

Sponsored by Rep. Ken King, R-Canadian, the bill would add additional medical cannabis product options allowed under Texas law, increase the state’s qualifying conditions, allow honorably discharged veterans to use medical cannabis for any condition, and license additional businesses to help ensure dispensaries can serve patients in all 11 of Texas’ public health regions.

The Lone Star State initially passed the Texas Compassionate Use Program in 2015, which limited access to products with no more than 0.5% THC on a dry-weight basis and only for patients with intractable epilepsy. State lawmakers expanded the program in 2019 and 2021, increasing the THC limit to 1% and the number of qualifying conditions to nine.

However, Texas law still lags behind 41 other states that have legalized some form of a medical cannabis program, the majority of which allow for high-THC cannabis products in smokable flower form and for patients with chronic pain to access dispensaries.

“Texans still struggle to get access to the medicine they’re legally allowed to receive,” King said Monday on the House floor. “There are not enough dispensing organizations licensed in the state, and current law limits how and where the products can be stored and distributed.”

According to the Texas Department of Public Safety (DPS), there were 110,026 unique patients in Texas’ compassionate use registry as of March 2025. However, a 2024 evaluation of the state’s low-THC program revealed that less than half of the state’s unique patients are active: About 45% of patients had filled at least one prescription in the past 12 months.

Accessibility is one factor impacting the participation rate.

Under H.B. 46, the DPS would be required to issue 11 vertically integrated licenses to “dispensing organizations” to ensure patient access in each of the state’s public health regions. Currently, only three dispensing organizations are licensed to serve patients in the nearly 270,000-square-mile area Texans call home.

“Right now, we have two licenses, really two and a half licenses in the state, and both of ’em are right here in Austin or Bastrop,” King said. “And so, the rest of Texas has a hard time accessing the law that we created.”

While the DPS opened an application window in early 2023 for new dispensing organizations—receiving 132 submissions from aspiring businesses—the department did not impose a deadline to approve any of the applications. At the time, DPS officials said they had no immediate plans to do so.

Under H.B 46, licensed medical cannabis businesses would also be allowed to operate satellite locations to securely store low-THC cannabis for distribution. Licensees would initially be limited to one satellite location in each public health region.

Specifically, the state’s current regulations that prevent medical cannabis companies from storing inventory anywhere but their primary locations proved burdensome during the state’s winter storm in February 2021, when historically low temperatures, icy roads and widespread power outages created a bottleneck for deliveries.

“The biggest challenge that we faced was our ability to get the medicine from our facility [located just outside Austin] to throughout Texas,” Texas Original Compassionate Cultivation’s then-CEO Morris Denton toldCannabis Business Times in 2021.

RELATED: How Texas Original Compassionate Cultivation Weathered the State’s Winter Storm

H.B. 46 would prohibit a municipality or county from establishing local regulations that would prevent the state’s licensed cannabis business from storing inventory within their jurisdictions.

The legislation would also increase patient access by adding the following qualifying conditions for which a physician would be authorized to recommend low-THC cannabis:

• a condition that caused chronic pain, for which a physician would otherwise prescribe an opioid;
• glaucoma;
• traumatic brain injury;
• spinal neuropathy;
• Crohn’s disease or other inflammatory bowel disease;
• degenerative disc disease;
• a terminal illness or a condition for which a patient is receiving hospice or palliative care; or
• a medical condition designated by the Department of State Health Services (DSHS) under the bill.

The bill would allow physicians to petition the DSHS to include additional qualifying conditions.

Currently, the state’s low-THC program is limited to patients with epilepsy, a seizure disorder, multiple sclerosis, spasticity, amyotrophic lateral sclerosis, autism, cancer, post-traumatic stress disorder or an incurable neurodegenerative disease.

Rep. Penny Morales Shaw, D-Houston, co-sponsored the legislation. She told her colleagues on the House floor that under the current low-THC cannabis program, too many Texans are forced to either suffer or self-medicate because they don’t have sufficient access.

“I had constituents that have been coming session after session, and this time they came with their medication package, which included a bunch of opioids,” she said. “And if they had just had access to this kind of medicine, less harmful medicine, they were basically saying it would keep them alive. So, this is a really important bill for I think a lot of our constituents that have this same experience that are in all of our districts.”

S.B. 46 would also revise the definition of “low-THC cannabis” to be limited to containing less than:

• 1% THC by weight in each dosage unit; or
• an amount of THC equivalent to 1% by weight in each dosage unit administered by pulmonary inhalation.

The legislation initially intended to limit low-THC product packages to no more than 1.2 grams of THC, but King offered a floor amendment stripping that language, leaving the dosage entirely up to the discretion of doctors.

“The amendment removes the 1.2-gram limit and allows physicians the ability to prescribe what they see fit for their patients,” he said. “This is in line with prescribing other prescription medications.”

Instead, S.B. 46 updates prescribing limits to include a 90-day supply with up to four refills.

While smoking cannabis through igniting or burning flower would remain prohibited under the legislation, S.B. 46 would amend state law to allow for inhalation of an aerosol or vapor as a means of administering low-THC medical cannabis. It would also allow for absorption (patches, lotions, etc.) and insertion (suppositories).

Currently, ingestion (edibles, beverages, tinctures) is the primary administration method under current Texas law.

While the Texas House approved legislation in April 2023 to expand the low-THC medical program, including increasing the THC limit to 5%, that bill ultimately stalled in the Senate.

House lawmakers would need to pass H.B. 46 on a third reading before officially sending it to the Senate this legislative session.