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Three Medical Cannabis Initiatives to Appear on Missouri Ballot

A close-up shot of a cannabis plant grown under Washington's I-502 market regulations.

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Missouri voters will get to choose from three different medical cannabis legalization initiatives this November, according to the Bolivar Herald Free Press. Two of the initiatives are constitutional amendments and the third is a statutory amendment.


Petition 2018-041 is a constitutional amendment that would:

The proposal is estimated to generate about $66 million in annual taxes and licensing fees. State officials estimated the initial implementation costs at $186,000 with annual operating costs of up to $500,000.

Petition 2018-051 is a constitutional amendment that would also codify medical cannabis into the Missouri State Constitution. It would:

  • legalize the use of medical cannabis and create regulations/licensing procedures for cannabis cultivators and manufacturing facilities.
  • Impose a 4 percent retail tax
  • Allocate funds from those taxes for health services for military veterans and fund the regulatory agency(s) for said medical cannabis program

It’s estimated the proposal would generate up to $18 million in annual taxes and licensing fees for state operating costs and veterans programs, and up to $6 million for local governments; approximately $7 million in annual state operating costs could be expected.

Petition 2018-271 is a statutory amendment that would amend Missouri law to:

  • Allow doctors to certify patients with a qualifying medical condition for the personal use and possession of medical cannabis.
  • Create a licensed and regulated industry for the growth, possession, production, and sale of medical cannabis.
  • Impose a 2 percent retail tax
  • Use the tax money to help fund veterans’ services, drug treatment, early childhood education, and public safety in cities with MMJ

State officials estimate the initial, one-time cost of this proposal to be $2.6 million with annual costs of up to $10 million; annual revenues should be at least $10 million. Local government officials estimate zero annual costs with at least $152,000 in annual revenues.


Missouri‘s current medical cannabis program is extraordinarily limited and exists largely in name only — it covers only epilepsy patients and allows only for hemp-derived CBD oils.

Missouri is in the minority of U.S. states without a comprehensive medical cannabis program. Earlier this year, Oklahoma became the 30th state to legalize medical cannabis.

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