“Today marks a small step forward, but we are up against incredible odds.”
By Zach Wendling, Nebraska Examiner
Health care practitioners who want to recommend medical cannabis to Nebraska patients are one step closer to having legal protections for writing the recommendation in the face of some state leaders’ opposition.
The Legislature voted 30-7 on Friday to advance Legislative Bill 933, from State Sen. John Cavanaugh of Omaha. It would protect medical providers from criminal, civil or disciplinary penalties “solely” for issuing a written recommendation or stating that in their professional judgment, the potential benefits of cannabis outweigh potential harms.
“It would create a step forward and hope and an opportunity for these families who have worked so hard, who have waited so long and would like to be able to have that conversation with their doctors and then potentially get some relief,” Cavanaugh said during debate.
Lawmakers clarified that the practitioner wouldn’t be protected from malpractice or professional negligence claims, such as for not evaluating a patient or following the appropriate standard of care. An amendment to that end from Cavanaugh passed 35-4, as did a similar amendment from the Legislature’s Health and Human Services Committee, in a separate 38-4 vote.
State Sen. Brian Hardin of Gering, HHS Committee chair, opposed LB 933 in committee but said the added language was an “important clarification.”
“Practitioners are protected for the recommendation itself but remain fully responsible for conducting a thorough and appropriate patient evaluation before making it,” Hardin said.
“Malpractice or professional negligence” is defined in law as failure to use “ordinary and reasonable care, skill and knowledge ordinarily possessed and used under like circumstances by members of his profession engaged in a similar practice in his or in similar localities.”
In the 2024 general election, 71 percent of voters legalized possession of up to 5 ounces of medical cannabis with a recommendation, and 67 percent of voters created the regulatory Nebraska Medical Cannabis Commission.
Getting to 33 votes
Similar provider protections were included in a bill offering a larger regulatory framework proposed in 2025, LB 677 from State Sen. Ben Hansen of Blair. The bill failed 23-22, short of 33 necessary votes to overcome a filibuster.
Cavanaugh’s LB 933 also would need 33 votes to change laws passed by voters, as required under the Nebraska Constitution.
There remains a path to get there, with 12 senators either absent from or sitting out Friday’s vote. One of them, State Sen. Rick Holdcroft of Bellevue, who was “present, not voting,” supported LB 677 10 months ago but did not vote to advance LB 933. He’s the lone LB 677 supporter in that boat.
Holdcroft helped get LB 677 out of the General Affairs Committee as committee chair. He said his biggest concern last year was funding for the commission, which is being remedied this year through state budget adjustments in LB 1071 and a separate General Affairs bill, LB 1235.
Holdcroft noted the Medical Cannabis Commission has just finished licensing four cultivators, who have indicated it might be eight months to a year before there is enough crop for manufacturing and later distribution.
“To start giving immunity to doctors who are going to make recommendations for a product that we’re not even going to have for a year is, I think, a little bit premature,” Holdcroft said.
Cavanaugh, Hansen and other advocates argue the protections are needed so an eventual state program can exist. To date, they say no in-state physician has issued a recommendation, in part over fear of retribution, such as from law enforcement. And without protections, supporters worry there will be no patients able to access commission-licensed facilities.
Nebraska Attorney General Mike Hilgers (R) rallied law enforcement against Hansen’s LB 677 in 2025 and spoke against the health care practitioner language. His office did not formally oppose LB 933, nor did the Nebraska Department of Health and Human Services.
‘Preponderance of scientific evidence’
State Sen. Jared Storm of David City, who led opposition to LB 677 last year, introduced an amendment to Cavanaugh’s bill to require that the health care practitioner’s recommendation be “based upon a preponderance of the current scientific evidence.”
Storm argued the “simple and straightforward addition” was rooted in the Hippocratic Oath to “do no harm.”
“If you’re against this amendment, you’re for recreational marijuana,” Storm said. “If you are for my amendment, you’re looking at this as medicine.”
Cavanaugh argued the opposite, that LB 933 would support advocates and not push them to instead rally for recreational marijuana due to delays of accessing medical marijuana. Hansen made a similar plea last year.
“If you do not want a recreational program, we must make our medical program functional,” Cavanaugh said.
Storm, Hansen and Cavanaugh alike said they aren’t aware of any doctors who have been sued for malpractice or negligence for recommending medical cannabis nationwide.
‘Moral hazard’ or ‘dangerous road’?
State Sens. Tanya Storer of Whitman and Bob Andersen of Sarpy County argued as Storm did that the debate was around public safety rather than medical cannabis.
Said Storer: “Immunity creates a moral hazard. When there are no consequences, there is less incentive to exercise caution.”
Cavanaugh and Hansen worried about the long-term implications of Storm’s proposal, arguing that it “muddies the water.” Hansen said it “could come back and bite us in the butt” around certain medications, such as Ivermectin used during the COVID-19 pandemic.
Cavanaugh said he had talked with the Nebraska Medical Association and the malpractice provider for the association, who Cavanaugh said told him that Storm’s amendment would “create more uncertainty.”
Hansen, a former HHS Committee chair, said he did understand where Storm was coming from and knows Storm’s opinion around medical cannabis. Hansen said using a “preponderance of scientific evidence” would exclude upward of 38 percent of medications issued off-label.
“I think we’re gonna go down a very dangerous road in the future about micromanaging how a medical professional can prescribe medication for the future,” Hansen said.
‘Bit of a fixer-upper’
State Sen. Carolyn Bosn of Lincoln, a former prosecutor, clarified with Cavanaugh that nothing in LB 933 would protect a professional’s license if they went against their professional judgment. She said the legal standard is based on someone’s education, training and experience. She supported the protections.
Storm said one issue was the difference between a “recommendation” for medical cannabis cannabis and a “prescription.” He noted opioids, for instance, are tracked under the state’s Prescription Drug Monitoring Program. Hansen proposed using that system in LB 677.
Hardin, who ultimately did not vote on the advancement of LB 933, said he supported Storm’s amendment. He said marijuana had been studied “since wagons were crossing within a mile of my house on the Oregon Trail,” and that with dozens of states legalizing marijuana, the question is how to do that in the “safest possible way.”
“I think it’s a little bit of a fixer-upper, and I think we’re getting there,” Hardin said.
Storm’s amendment failed 22-19. It’s possible he may try again in future debate, as five senators were not at the State Capitol on Friday, including Storer.
‘Small step forward’
Crista Eggers of Nebraskans for Medical Marijuana said she was encouraged by the advancement of LB 933 but that some of the debate, particularly around Storm’s amendment, shows continued opposition to a functioning state program.
“Today marks a small step forward, but we are up against incredible odds as this bill looks to move on to select file and final reading,” Eggers said after the vote.
“Nebraskans have had few wins in this over-decade-long fight,” she continued. “Today is one of them.”
LB 933 faces up to two more rounds of debate before, with 33 votes, it could be sent to Nebraska Gov. Jim Pillen for his signature.
Vote to advance Legislative Bill 933 related to medical cannabis
Aye (30): John Arch, Carolyn Bosn, Eliot Bostar*, Tom Brandt*, John Cavanaugh*, Machaela Cavanaugh*, Stan Clouse*, Danielle Conrad*, Wendy DeBoer*, Barry DeKay, Myron Dorn*, George Dungan*, John Fredrickson*, Dunixi Guereca*, Ben Hansen*, Jana Hughes*, Megan Hunt*, Margo Juarez*, Terrell McKinney*, Fred Meyer, Glen Meyer*, Jason Prokop*, Dan Quick*, Jane Raybould*, Merv Riepe, Victor Rountree*, Rita Sanders, Ashlei Spivey, Brad von Gillern and Dave Wordekemper*.
Nay (7): Bob Andersen, Rob Clements, Mike Jacobson, Kathleen Kauth, Loren Lippincott, Dave Murman and Jared Storm.
Present, not voting (7): Christy Armendariz, Beau Ballard, Brian Hardin, Rick Holdcroft*, Teresa Ibach, Mike Moser and Tony Sorrentino.
Excused, not voting (5): Rob Dover, Bob Hallstrom, Dan Lonowski, Tanya Storer and Paul Strommen.
*Voted for a broader medical cannabis framework proposed in 2025 (Legislative Bill 677).
