By Steph Sherer for The Hill

The 2016 election will have lasting effects on the future of medical cannabis programs that affect the lives of millions of Americans. This is not a year to sit on the side lines. Educate yourself and vote!

Today, more than 300 million Americans live in states with medical cannabis laws, and over 2 million individuals are legally using medical cannabis under their state programs. However, these patients and programs technically violate federal law, but this could all change on Nov. 8.

For the past three years, state sponsored medical cannabis programs have operated under the guidance of federal agency memos and Congressionally imposed spending restrictions, which have limited federal interference and created  a “cease-fire” for states implementing medical cannabis programs.

The relative détente between state programs and federal enforcement has spurred an increase in the number of states with medical cannabis laws, allowing these states to move forward with more robust licensing requirements and product safety protocols.

Because the current regulatory situation is a combination of agency policy memos and appropriations amendments that must be renewed annually, the election and subsequent changes in the executive and Congress would have a major impact on potential legalization of medical cannabis.

The Next President

Before the second term of the Obama administration, the federal government spent nearly $500 million dollars in federal enforcement against medical cannabis programs. Essentially every agency in the federal government approached medical cannabis in this same fashion — all marijuana is illegal under federal law. While state laws slowly moved forward and more people became legal medical cannabis patients, the federal government’s response remained stagnate.

In 2013 the Department of Justice (DOJ) issued detailed guidelines for U.S. attorneys, instructing them to leave state-compliant medical cannabis programs alone. In response, many agencies shifted their approach to medical cannabis but further progress is in the hands of the president of the United States.

This is the first year that all nominees have publicly supported medical cannabis in some way. Clinton’s positions are much clearer than Trump’s; Johnson and Stein are also more specific.

Trump, who last year affirmed his support of medical cannabis, has said he would put Christie in charge of his transition team and has hinted that he would likely appoint him Attorney General. Yet, while he campaigned for the Republican nomination, Christie said:

“Marijuana is against the law in the states and it should be enforced in all 50 states...That’s the law and the Christie administration will support it.”

Trump’s next most likely Attorney General nominee would be Rudy Giuliani, who, while on the 2008 presidential campaign trail, said of medical cannabis:

"You can accomplish everything you want to accomplish with things other than marijuana, probably better. There are pain medications much superior to marijuana."

Clinton, by contrast, said:

“I think what the states are doing right now needs to be supported, and I absolutely support all the states that are moving toward medical marijuana, moving toward — absolutely — legalizing it for recreational use.

“What I’ve said is let’s take it off the what’s called Schedule I and put it on a lower schedule so that we can actually do research about it. There’s some great evidence about what marijuana can do for people who are in cancer treatment, who have other kind of chronic diseases, who are suffering from intense pain.”

When casting a vote for the next president of the United States, medical cannabis users and advocates should be asking themselves, “who do I want setting policy for the Drug Enforcement Administration, Department of Justice, National Institutes of HealthFood and Drug Administration, and other — all of which have a role to play in cannabis policy — for the next four years?”

Medical Cannabis Champions up for Reelection

Aside from DOJ guidance memos, the current “ceasefire” comes from an amendment added to the Commerce, Justice and Science committee budgets.

Known as the Rohrabacher-Farr or CJS amendment, it not only prevents direct interference with state implementation; but also ended federal medical cannabis raids, arrests, criminal prosecutions, and civil asset forfeiture lawsuits.

This interpretation has been upheld in the federal courts in three cases; U.S. v. Marin Alliance for Medical MarijuanaU.S. v. Harborside, and U.S. v. McIntosh. Signed into law on Dec. 16, 2014 (and then again on Dec. 18, 2015), if the amendment is not renewed for 2017 these protections will vanish and U.S. attorneys could resume prosecutions.

In order to continue to pass federal legislation we need to retain as many medical cannabis champions as possible.

Americans for Safe Access has created a voter guide for medical cannabis advocates to quickly identify supporters in Congress to inform their decision for representation on November 8th.

The Future of Medical Cannabis and Chuck Grassley

The only way that medical cannabis laws can move out of the “cease-fire” limbo into full “peace accord” will be through an act of Congress.

Medical cannabis policy has fared well in a Republican house but has been stalled in Senate, primarily due to Iowa Sen. Chuck Grassley’s position as Republican chair of the Justice Committee.

Despite bipartisan support in his own committee, Grassley, who is currently up for reelection, has refused to give the Compassionate Access, Research Expansion, and Respect States(CARERS) Act a hearing in his committee. With his re-election looking likely, a Democratic Senate may be the only way to dislodge him from this position in the 115th Congress.

Justice isn’t the only committee that will affect medical cannabis policy in the 115th Congress. Senator Barbara Mikulski (D-Md.) is retiring this year, and medical cannabis advocates will be hard pressed to have a champion as powerful as her. She pushed through the CJS amendment in the 113th Congress as majority chair of Appropriations and twice as minority chair in the 114th Congress.

This means the Senate races in Illinois, Wisconsin, Florida, Indiana, Missouri, Nevada, New Hampshire, North Carolina, and Pennsylvania will play a major role in our ability to end the federal conflict with medical cannabis in the 115th Congress.

Ballot Initiatives

Cannabis policy is on the ballot in 9 states this year.

North Dakota, Montana, Arkansas, and Florida are all voting on medical cannabis, while California, Maine, Nevada, Arizona and Massachusetts will be voting on adult use.

If all the medical cannabis initiatives pass it will bring the number of states with comprehensive medical cannabis laws to 29, and change the number of states with CBD only laws from 16 to 15, as Florida would progress from CBD to comprehensive access.

The 2016 election will have lasting effects on the future of medical cannabis programs that affect the lives of millions of Americans. This is not a year to sit on the side lines. Educate yourself and vote!