Only nine states remain without comprehensive medical marijuana laws, leaving the United States closer than ever to nationwide medical access.
The federal government’s April 2026 decision to move state-regulated medical marijuana to Schedule III could also give hesitant lawmakers additional political cover to support reform. At the state level, several proposals have repeatedly received bipartisan support or advanced through at least one legislative chamber, putting them in a good position to get legalization over the finish line in the coming months and years.
With that in mind, below are the six states most likely to legalize medical cannabis in 2027 or 2028.
North Carolina
North Carolina has come closer to legalizing medical marijuana than nearly any other state remaining on the list.
The state Senate approved the North Carolina Compassionate Care Act in 2022 and again in 2023, with the latter proposal passing 36 to 10. The measure would have established a tightly regulated system for patients with qualifying conditions, including cancer, epilepsy, post-traumatic stress disorder and terminal illnesses. Both versions stalled after reaching the House.
Lawmakers introduced another version, House Bill 1011, in April 2025, although it remained in the House Rules Committee through the end of the 2025-2026 session.
Gov. Josh Stein (D) has created additional momentum by establishing the North Carolina Advisory Council on Cannabis. Although the council is examining a broader regulated adult-use market, its work could produce recommendations that include medical access or give lawmakers a framework for a medical-only compromise. The council is scheduled to continue meeting through at least November 2026.
Repeated Senate approval, support from an influential group of Republican lawmakers and a governor actively examining cannabis regulation place North Carolina near the top of the list heading into 2027.
South Carolina
South Carolina lawmakers have debated medical marijuana for more than a decade, with legislation twice receiving approval from the Republican-controlled Senate.
The Senate voted 24 to 19 in February 2024 to approve the South Carolina Compassionate Care Act. A similar proposal previously passed the chamber but was blocked in the House because it contained a fee that legislative leaders said was required to originate in the House.
The proposal would have allowed patients with certain serious medical conditions to access products such as oils, capsules, topical products and cannabis intended for vaporization. Smoking marijuana and home cultivation would have remained prohibited.
State Senator Tom Davis (R) introduced another version as Senate Bill 53 for the 2025-2026 session. However, the measure remained in the Senate Medical Affairs Committee and did not receive a vote before lawmakers adjourned.
The November 2026 gubernatorial election could improve the proposal’s prospects. Attorney General Alan Wilson, who won the Republican nomination for governor in June, said during the primary campaign that he was open to allowing medical marijuana. Wilson is favored in a state where Democrats have not won a gubernatorial election since 1998.
With the Senate already demonstrating that it can pass a restrictive medical cannabis bill, support from the next governor could provide the final push needed in 2027 or 2028.
Wisconsin
Wisconsin remains surrounded by states with comprehensive medical marijuana programs, but disagreements among Republican lawmakers have repeatedly prevented legislation from reaching the governor.
That opposition has begun to soften. Republican lawmakers introduced Senate Bill 534 and Assembly Bill 547 in 2025, proposing a regulated medical cannabis system with licensed growers, processors, testing laboratories and dispensaries.
The restrictive proposal would not have allowed smoking or home cultivation, and patients would have needed a recommendation for an approved qualifying condition. Seven Republican senators sponsored the Senate version, demonstrating that medical marijuana now has at least some support within the majority party.
The measure received a committee hearing but failed to pass before the Legislature ended its regular work in March 2026.
Wisconsin will elect a new governor in November 2026 because Gov. Tony Evers (D), a longtime supporter of marijuana legalization, is not seeking another term. Legislative elections could also alter the balance of power in chambers where Republican majorities are considerably narrower than they were before the state adopted new electoral maps.
Even if Democrats do not gain control, the introduction of a detailed Republican-sponsored proposal indicates that the debate is shifting toward what a medical program should look like rather than whether one should exist.
Kansas
Kansas has considered medical marijuana legislation numerous times, and the policy has previously received substantial bipartisan support in the state House.
In 2021, representatives voted 79 to 42 to approve a comprehensive medical marijuana bill. The proposal stalled after reaching the Senate, where Republican leaders have continued to block medical cannabis measures from receiving floor votes.
Lawmakers introduced the Kansas Medical Cannabis Act as House Bill 2678 in February 2026. It would have authorized the cultivation, processing, distribution and sale of marijuana to registered patients. However, the measure was not granted a hearing before the session ended.
Gov. Laura Kelly (D) has repeatedly called for medical marijuana legalization, but she is term-limited and cannot seek reelection in November 2026. The race to replace her could significantly affect the issue’s prospects.
All major Democratic candidates running ahead of the August primary have said they support at least medical cannabis legalization, while the leading Republican candidates have not endorsed the policy.
Kansas lacks a citizen initiative process that would allow supporters to bypass the Legislature, making the outcome of the gubernatorial and legislative elections especially important. A favorable election result could return medical marijuana to the House floor in 2027 and increase pressure on the Senate to finally hold a vote.
Indiana
Indiana has traditionally been among the most resistant states to marijuana reform, but recent comments from Republican officials suggest that medical legalization could receive serious consideration in 2027.
Gov. Mike Braun (R) has said it may be time for the state to address therapeutic marijuana access, particularly as each of Indiana’s neighboring states allows medical cannabis. Braun has also criticized legislative leaders for refusing to meaningfully debate broader marijuana policy.
State Senator Mike Bohacek (R) announced in May 2026 that he had begun drafting legislation for the 2027 session that would legalize and regulate medical marijuana. The proposal is expected to address production, sales, taxation and qualifying patient access.
Major barriers remain. Senate President Pro Tem Rodric Bray (R) has long opposed legalization, while House Speaker Todd Huston (R) has questioned whether marijuana has legitimate medical benefits. Their positions have prevented previous proposals from advancing.
Still, a Republican governor and Republican state senator publicly calling for action represents a notable change. Federal recognition of state-regulated medical marijuana could further weaken arguments that Indiana should wait for Washington before establishing its own program.
Iowa
Iowa already operates a limited medical cannabidiol program, but it is not considered a comprehensive medical cannabis system because flower and smoking remain prohibited and patients generally face a limit of 4.5 grams of THC every 90 days.
The state nevertheless has licensed manufacturers, registered patients and dispensaries, giving lawmakers an existing system that could be expanded rather than requiring them to create an entirely new market.
In June 2026, Gov. Kim Reynolds (R) signed House File 990, doubling the maximum number of medical cannabis dispensaries from five to 10. The proposal passed the House 88 to 5 and the Senate 42 to 5, showing overwhelming bipartisan support for improving patient access.
Lawmakers have also considered House File 950, which would have expanded the definition of medical cannabidiol to include cannabis flower intended for inhalation. The proposal advanced through an initial committee but did not receive final approval before the session ended.
The November 2026 election could accelerate further changes. Democratic gubernatorial nominee Rob Sand has proposed legalizing and regulating marijuana for adults, meaning he would almost certainly support converting Iowa’s limited system into a comprehensive medical program.
Even without a change in party control, the nearly unanimous approval of the dispensary expansion indicates that Iowa lawmakers are willing to gradually broaden medical cannabis access. Allowing inhalable flower, removing restrictive THC limits or authorizing additional products could move Iowa into the comprehensive medical cannabis category by 2027 or 2028.
