In 2014, the Iowa legislature passed the “Medical Cannabidiol Act” which allows licensed neurologists and other health care practitioners to certify patients with intractable epilepsy to use CBD with 3 percent or less THC content. Qualifying patients must obtain a registry card to be eligible to receive legal protection, and patients may designate a caregiver to assist them. The law does not impose a minimum amount of CBD, but also does not extend legal protections to those with products that have more than 3 percent THC. 

In 2017, Governor Brandstad enacted HF 524, which expanded legal access to patients with Parkinson’s, cancer, multiple sclerosis, seizures, HIV/AIDS, Crohn’s disease, ALS, most terminal illnesses with life expectancy less than one year and untreatable pain. Adding untreatable pain is a step in the right direction for those affected by the opioid crisis, but the definition of pain remains limited. The law also allows for the production of low-THC cannabis products in the state creating a framework for growing, manufacturing, and distribution companies to submit proposals to the state. Iowa could still vastly improve on developing robust product safety regulations and increasing accessibility to medicine.

In 2018, the state issued five licenses for CBD dispensaries, and sales of medical cannabis products (capped at 3 percent THC) began in December of 2018.  In 2019, Iowa regulators added autism spectrum disorders and ulcerative colitis as qualifying conditions and moved to allow inhaled forms of cannabis for patients.