In November 2023, we pondered whether 2024 might be “the year” for medical marijuana legalization in North Carolina. Well, it wasn’t.

Why, you ask? How can a state whose population has expressed overwhelming bipartisan support for medical marijuana legalization still have nothing to show for it? How can a state whose Senate has shown overwhelming bipartisan support (see Senate Bill 3 and Senate Bill 711) for medical marijuana legalization still have nothing to show for it?

Under former House Speaker Tim Moore (R), whose tenure ended earlier this year when he transitioned to serving as a United States congressman, North Carolina Republicans adhered to an informal yet influential guideline: A bill would not reach the House floor unless a majority of Republican House members supported it. Because the 2023-2024 session contained 72 Republicans (out of 120 total seats), 37 Republican supporters were needed for any bill to secure a House vote. In the current session (2025-2026), one less Republican was elected to the House, meaning there are now 71 Republicans, with 36 Republicans creating a “majority of the majority.” This unwritten rule has been the key obstacle to medical marijuana legislation in North Carolina despite its clear bipartisan support.

For example, in 2023, a bipartisan group of senators passed the North Carolina Compassionate Care Act (SB 3) by a margin of 36-10. The act ultimately stalled, however, because it didn’t have support from the requisite 37 House Republicans. Before that, a previous version of the bill (SB 711) passed the Senate by a similar margin and died in the House for the same reason. After that, HB 563, originally a hemp regulation bill, was amended to include medical marijuana provisions from the North Carolina Compassionate Care Act. The bill shared the same fate.

Could It Be Destin[y]?

Earlier this year, Destin Hall (R) replaced Moore as speaker of the House. Despite Hall’s public opposition to medical marijuana reform, there are two reasons to be optimistic about what his tenure might mean for the future of medical marijuana in North Carolina.

First, Hall may choose to abandon Moore’s “majority of the majority” rule, removing the roadblock that killed the North Carolina Compassionate Care Act in 2022, 2023, and 2024. Without strict enforcement of the vote threshold, medical marijuana legislation would likely pass. To date, we’re not aware of any indication Hall has given with respect to whether he intends to continue the rule’s enforcement.

Second, Hall, in reference to medical marijuana, recently indicated that “House Republicans could be more open to what the Senate sends over to them.” In other words, even if the “majority of the majority” rule remains in place, it’s still possible for medical marijuana legislation to pass. It’s unclear how many House Republicans supported SB 711, SB 3, and HB 563. However, if the margin in the Senate is any indication, the number of Republican supporters could already be approaching the threshold.

With President Trump publicly showing support for marijuana legislation, Republican support for legalizing marijuana increasing significantly over the last decade – especially among the younger members of the party – 12 new younger Republican House members, a new speaker of the House, and the “majority of the majority” threshold itself decreasing by one, there is reason for (very) cautious optimism regarding the potential passage of medical marijuana legislation in North Carolina this session.

Clearing the Haze: A Refresher on the N.C. Compassionate Care Act for Those Who Might Have… Uh, Forgotten

It’s unclear what a new (and improved?) version of the North Carolina Compassionate Care Act might look like, or if the next piece of medical marijuana legislation to reach the House will be a version of that act at all. That said, as a reminder to our readers, here’s what it would have done if it had passed.

On the consumer side, it would have allowed individuals in North Carolina to obtain a prescription to purchase marijuana in connection with a limited list consisting only of severe medical conditions, including:

• Cancer
• Epilepsy
• HIV
• ALS
• Crohn’s disease
• Sickle cell anemia
• Parkinson’s disease
• PTSD
• Multiple sclerosis
• Cachexia (wasting syndrome)
• “Severe or persistent nausea” related to terminal illness or hospice care

On the business side, up to 10 companies would have been granted licenses to control the supply and sale of marijuana, with each supplier permitted to operate up to eight dispensaries.

On the regulatory side, it would have created the Medical Cannabis Production Commission, tasked with overseeing licensing and supervising the state’s marijuana supply and the program’s revenue generation.

The Higher Perspective: A Broader Update on N.C.’s Cannabis Policies

North Carolina is in a bit of a cannabis pickle. No, not a cannabis-infused pickle. Although – apparently, that’s a real thing. We mean, at the risk of sounding a bit Harry Potter-ish, that its policies are a bit of a cannabis contradiction.

While, as we have discussed, North Carolina has been a bit of a straggler when it comes to marijuana legalization, hemp is minimally regulated.

As we have reported, under North Carolina law, “hemp” means the plant Cannabis sativa and any part or derivatives of that plant, with a delta-9 THC concentration of no more than three-tenths of 1% (0.3%) on a dry weight basis. Marijuana is derived from the same plant and is a label applied to concentrations over that amount.

Recently, the Senate introduced the Protecting Our Communities Act (SB 265), which purports to establish a comprehensive regulatory framework surrounding hemp products. The bill would introduce certain licensing, packaging, manufacturing, distribution, laboratory testing, and advertising regulations, including a myriad of civil and criminal penalties that would result from non-compliance.

Perhaps most notably, SB 265 would establish an age requirement for hemp products, prohibiting and penalizing anyone under the age of 21 from possessing or purchasing these products.

We’ve been here before—but this time, the climate might actually be right. Stay tuned to find out whether North Carolina turns over a new leaf this session.