Texas lawmakers came to a bicameral agreement on expanding the state’s low-potency medical cannabis program, focusing on qualifying conditions, business licenses and dosing options that could replace the state’s 1% THC cap.

The cross-chamber agreement led to the Senate amending and passing House Bill 46 on May 27, legislation that will expand the Texas Compassionate Use Program (TCUP) that was initially enacted in 2015 and expanded in 2019 and 2021. Under the 2025 proposal, those with chronic pain, on hospice care or diagnosed with a terminal illness will qualify for the program. This is in addition to the program’s nine current qualifying conditions.

Texas Sen. Charles Perry, R-Lubbock, who carried the upper chamber’s version of the bill, explained this week on the floor that “chronic” pain, as opposed to acute pain, is defined by the Texas Medical Board.

“We had to have kind of a stake in the ground: What is chronic pain according to the medical industry?” Perry said. “The [distinction] is acute pain versus chronic, right? Acute is if I smash my finger with a hammer—that’s pretty acute, but it’s not going to last 90 days. [Chronic] is something that normal practices can’t alleviate the pain for more than 90 days.”

Previous to Senate amendments, the House’s version of H.B. 46 included several other proposed qualifying conditions, from glaucoma to traumatic brain injuries, spinal neuropathy, Crohn’s disease, degenerative disc disease and any condition impacting an honorably discharged veteran. However, the Senate State Affairs Committee stripped the bill of these proposed conditions earlier this month.

One of Perry’s seven amendments that lawmakers adopted this week on the Senate floor added chronic pain back into the bill as a qualifying condition.

In addition, the legislation requires the Texas Department of Public Safety (DPS) to increase the number of licensed businesses from three to 12 in an effort to ensure geographical access points throughout the state.

The program’s vertically integrated licensees, referred to as “dispensing organizations,” would also be allowed to operate satellite locations to securely store low-THC cannabis products for distribution in each of the state’s 11 public health regions. Under current law, dispensing organizations can only operate one primary location, making deliveries to certain regions of Texas expensive and not always timely.

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“A large part of the cost of delivery of the medical cannabis was the actual distribution point,” Perry said. “This will alleviate a lot of the costs because they’ll be able to store it in those locations and be able to distribute. Right now, currently, if you need it and you live in Lubbock, the manufacturer/retailer has to bring it to you from Austin … that’s a large part of the cost of this product is just getting it to the persons that are needing it.”

Another floor amendment from Perry requires the DPS to issue at least three of the additional nine business licenses by Oct. 1, 2025. Those first three licenses would need to be issued to those who applied through a previous application window that the DPS opened in early 2023, when the department received 132 submissions from aspiring businesses.

The DPS would need to issue the final six of the additional nine licenses by April 1, 2026, with the department having the discretion to consider new applicants outside the 2023 window.

Another Perry amendment states that, based on a competitive application evaluation process, the DPS is to give licensing preferences to Texas-based companies whose owners are state residents.

In addition, any licensed TCUP business owner who controls more than 10% of a company would be required to comply with a fingerprinting background check and register with the DPS.

“We wanted to kind of know who’s owning these companies to the best of our ability,” Perry said.

Meanwhile, the underlying bill includes expanded dosing options that doctors can prescribe to patients, including up to a 90-day supply with up to four refills per year.

More specifically, the Senate State Affairs Committee amended the definition of “low-THC cannabis” so that no more than 10 milligrams of THC could be in each dosage unit a doctor prescribes to a patient, rather than relying on a 1% THC cap in the definition.

To date, many pro-cannabis advocates don’t recognize Texas as a medical cannabis legalized state due in part to the restrictive nature of its THC limit.

Sen. José Menéndez, D-San Antonio, told his colleagues on the floor that he’s advocated for a true medical cannabis program for the last 10 years.

“This is the only medical therapy where we as legislators, for some reason, think that we know more than the doctors,” he said. “They know for a fact that narcotics are a hundred times worse for us than cannabis.”

In addition to allowing doctors to prescribe medical cannabis dosages based on individual patient needs, H.B. 46 would allow for low-THC cannabis to be administered through pulmonary inhalation of an aerosol or vapor, providing patients with a more rapid delivery method for certain conditions. Absorption (patches, lotions, etc.) and insertion (suppositories) would also be allowed.

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

Sen. Roland Gutierrez, D-San Antonio, also spoke in support of the bill this week on the Senate floor, saying that U.S. military veterans who went to battle in Iraq and Afghanistan are often limited to opioids in the Veterans Affairs health care system. While the Senate’s version of H.B. 46 does not provide a pathway for veterans to access medical cannabis for any condition, those with post-traumatic stress disorder already qualify under TCUP.

“The most important term there is that we will regulate this industry in a right way so that we can continue to help the commitment that we have to our veterans, because there will be other battles and there will be other theaters of war,” Gutierrez said. “And when they come home, we’ll give ‘em a product that is less addictive than the hydrocodone, that doesn’t cause them to have suicidal tendencies, that doesn’t have them walking around like zombies, that frees them of their pain under a regulated setting … that’s why this bill is so important.”

Gutierrez also spoke about the state’s commitment to safeguarding children from intoxicating products in the aftermath of Texas Senate and House lawmakers concurring on legislation May 25 to ban hemp products that contain cannabinoids other than nonintoxicating CBD or CBG.

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Texas Lt. Gov Dan Patrick, who presides over the state Senate and spearheaded the legislation to ban intoxicating hemp products, said this week that state lawmakers chose to eradicate “bad actors who are poisoning our community, children and adults and making a massive profit off the backs of people in pain and people who have gotten hooked on THC. … We’ve wiped them out.”

Patrick commended Senate members for instead focusing on building “the biggest” compassionate use program in the country.

“It’s a good one, two combination,” he said.

Texas had 112,495 patients registered in TCUP as of April 2025, according to the DPS.

The Texas House will need to concur on the Senate’s amendments to H.B. 46 before sending the medical cannabis expansion proposal to Gov. Greg Abbott’s desk for consideration.