Medical marijuana laws are now in effect in 41 states, leaving nine without comprehensive programs: Idaho, Indiana, Iowa, Kansas, North Carolina, South Carolina, Tennessee, Wisconsin and Wyoming.
The distinction is important. Iowa operates a limited medical cannabidiol system, while several other states provide narrow legal protections for CBD or low-THC products. However, those policies generally do not provide the range of qualifying conditions, products, legal protections and regulated access associated with comprehensive medical marijuana programs. As recently as earlier this year Georgia and Texas were included in this category, but both have since enacted laws significantly expanding their programs.
With that in mind, below is a look at the states that haven’t legalized medical cannabis.
Idaho
Idaho remains the only state without a law recognizing the medical use of marijuana, CBD or other cannabis-derived products.
Advocates with the Natural Medicine Alliance of Idaho attempted to place a medical marijuana initiative on the November 2026 ballot. The proposal would have allowed patients with qualifying medical conditions to obtain marijuana with a physician’s recommendation and established a regulated system of licensed businesses.
Organizers submitted more than 150,000 signatures, but election officials verified only 58,024. The campaign needed at least 70,725 valid signatures, along with signatures from 6% of registered voters in at least 18 of Idaho’s 35 legislative districts. The initiative officially failed to qualify in July.
Voters will instead consider House Joint Resolution 4 on November 3. The legislatively referred constitutional amendment would give the Idaho Legislature exclusive authority to legalize marijuana and certain other controlled substances, preventing voters from doing so through future ballot initiatives.
Indiana
Indiana law allows the possession and sale of hemp-derived CBD products containing no more than 0.3% THC, but the state does not have a medical marijuana program.
Senate Bill 286, introduced in January 2026, proposed creating a regulated marijuana market for adults aged 21 and older and people with serious medical conditions. The measure was assigned to the Senate Commerce and Technology Committee but did not receive approval before the session ended.
Although the bill stalled, State Senator Mike Bohacek announced in May that he was developing a medical marijuana proposal for the 2027 legislative session. Bohacek said the legislation would address medical eligibility, taxation, distribution, healthcare standards and laws involving impaired driving.
Iowa
Iowa operates a Medical Cannabidiol Program that allows registered patients to purchase certain products from licensed dispensaries. However, the system remains substantially more restrictive than comprehensive medical marijuana programs in most other states.
House File 950 sought to expand the program by allowing patients aged 21 and older to purchase vaporizable dried cannabis. The proposal advanced through a House committee during the 2025 session but never received a floor vote and remained unfinished when the two-year legislative session concluded.
Lawmakers did approve a more limited expansion in 2026. House File 990, signed into law in June, increased the maximum number of medical cannabidiol dispensaries from five to 10 and made several changes to licensing and patient registration requirements. The law took effect July 1.
The expansion improves access for existing patients but does not transform Iowa’s system into a comprehensive medical marijuana program.
Kansas
Kansas provides an affirmative legal defense for certain patients possessing CBD oil containing no more than 5% THC. However, the state does not authorize the production or sale of those products, leaving patients without legal in-state access.
Senate Bill 294, introduced in 2025, would have established the Kansas Medical Cannabis Act and authorized the cultivation, processing, distribution, sale and medical use of marijuana. The bill remained in committee without receiving a hearing during either the 2025 or 2026 session.
House Bill 2678 was introduced in February 2026 with similar provisions for a regulated medical marijuana program. It also failed to advance from committee before lawmakers adjourned in April. Other unsuccessful proposals included House Bill 2752 and a proposed constitutional amendment that would have asked voters to decide the issue.
North Carolina
North Carolina does not have a statewide medical marijuana program, although the federally recognized Eastern Band of Cherokee Indians operates a marijuana market on tribal land.
House Bill 1011, titled the North Carolina Compassionate Care Act, was introduced in April 2025. The measure would establish a Medical Cannabis Production Commission, create patient and caregiver registries and license businesses to produce and distribute marijuana to people with qualifying medical conditions.
The bill was referred to the House Rules Committee one day after its introduction and had not advanced as of July 2026.
Lawmakers also introduced House Bill 984, which would regulate medical marijuana research, as well as broader proposals that included both medical and recreational legalization. None reached a floor vote.
Governor Josh Stein supports going further than medical marijuana legalization by creating a regulated recreational market for adults. Stein established the North Carolina Advisory Council on Cannabis in June 2025 and directed it to develop recommendations for a system that allows adult sales while protecting public health and minors. After the council issued its interim report in April 2026, Stein called for the state to create a “safe, legal, and well-regulated market for adults.”
South Carolina
South Carolina’s Julian’s Law allows qualifying patients with severe epilepsy to use certain low-THC cannabis products. The state also has a medical marijuana research law dating to 1980, but it never resulted in an operating program with legal access for patients.
Lawmakers again considered the South Carolina Compassionate Care Act during the 2025-2026 session. Senate Bill 53 would have created a regulated medical marijuana program for patients with qualifying debilitating conditions.
House Bill 3019, known as the Put Patients First Act, proposed a separate and more expansive medical marijuana framework. The measure was referred to the House Medical, Military, Public and Municipal Affairs Committee but did not advance.
A third proposal, House Bill 3018, would have provided limited possession protections for veterans diagnosed with combat-related post-traumatic stress disorder. All three measures failed to reach enactment before the session ended.
Tennessee
Tennessee law provides limited exceptions for oils containing less than 0.9% THC when used by certain patients with seizure disorders or as part of approved research. The state does not license businesses to produce or sell medical marijuana, forcing patients who qualify for the exception to obtain products elsewhere.
House Bill 872 and its Senate companion, Senate Bill 489, were introduced in February 2025 as the Tennessee Medical Cannabis Act. The legislation would have established a commission, created patient identification cards and authorized regulated businesses to produce and distribute marijuana.
Proposed qualifying conditions included cancer, chronic pain, post-traumatic stress disorder and terminal illnesses.
Senate Bill 489 failed in the Senate Judiciary Committee on February 25, 2025, after no member offered a motion to consider it. The House version was assigned to the Health Subcommittee but did not advance before the end of the 2025-2026 session.
Wisconsin
Wisconsin allows limited possession of certain CBD products but does not have a regulated medical marijuana market.
Republican lawmakers introduced Senate Bill 534 and Assembly Bill 547 in 2025. The proposals would have created patient and caregiver registries and licensed marijuana growers, processors, testing laboratories and dispensaries.
The legislation focused on medical preparations rather than smokable marijuana and would have required patients to consult with a pharmacist when obtaining products.
The Senate Health Committee approved Senate Bill 534 in February 2026, marking one of the most significant advances for a medical marijuana bill in Wisconsin. However, Senate leaders did not bring it to the floor before the legislative session ended in March. The Assembly version did not receive a committee hearing.
Democratic lawmakers also introduced broader legislation that would have legalized marijuana for both medical and recreational use, but those proposals did not advance.
Wyoming
Wyoming law allows people with intractable epilepsy or seizure disorders to possess hemp extracts containing no more than 0.3% THC and at least 5% CBD. The state does not provide regulated access to those products or recognize marijuana for other medical conditions.
House Bill 166, introduced during the 2026 budget session, proposed moving marijuana from Schedule I to Schedule III under Wyoming law. The bipartisan measure would have changed the legal classification of marijuana but would not by itself have created a patient registry, dispensary system or comprehensive medical program.
The Wyoming Legislature declined to consider the bill for introduction in February, effectively ending it for the session.
Wyoming officials subsequently decided in July to continue classifying marijuana as a Schedule I substance under state law despite changes at the federal level. State officials noted that lawmakers had not legalized medical marijuana or established a system to regulate its use.
