The State of Medical Marijuana in Iowa

2020 Grade: F

2015 2016 2017 2018-2019 2020

2019-2020 Improvements and Recommendations

In 2020, Governor Reynolds signed HF 2589 into law19, which expands the list of eligible medical conditions under the state’s medical cannabis program to include chronic pain and PTSD. The legislation also permits physician assistants, advanced practice nurses and podiatrists to recommend cannabis for treatment, and increases the THC cap for authorized cannabis products from 3 percent to allow a total of 4.5 grams of THC every 90 days. While these are positive developments, the same bill also permits landlords and employers to ban medical cannabis use by registered patients. Iowa is making important strides in expanding its medical program, however removing patient protections works directly against these efforts.

ASA encourages Iowa lawmakers to organize a comprehensive medical cannabis program, that provides protections for patients who rent, as well as protections from employers that permit patients to use cannabis as a medicine without fear of losing employment. Such a program should remove arbitrary THC caps, and permit the cultivation, manufacturing, testing, distribution and retail of medical cannabis and cannabis products for patients.


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.

Patient Feedback

Many surveyed patients report being pleased that the list of qualifying conditions for medical cannabis has expanded. Other surveyed patients appreciate that higher THC content is allowed in the state, but wish that additional forms of cannabis products were available to them. Surveyed patients also report that the cost of medical cannabis is still very high in the state.