“Today is a small step forward, but we are facing terrible prospects.”

Zach Wendling, Nebraska Examiner

Health care Practitioners wishing to recommend medical cannabis to patients in Nebraska They are one step closer to having legal protections to write the recommendation in the face of opposition from some state leaders.

The Legislature voted 30-7 Friday to advance House Bill 933 by state Sen. John Cavanaugh of Omaha. It would protect medical providers from criminal, civil or disciplinary penalties “merely” for providing a written recommendation or stating that, in their professional opinion, the potential benefits of cannabis outweigh the potential harms.

“It would create a step forward and hope and opportunity for these families who have worked so hard, waited so long and would like to have that conversation with their doctors and then get some relief,” Cavanaugh said during the discussion.

Legislators clarified that the practitioner would not be protected from malpractice or professional negligence claims, such as failing to evaluate a patient or follow an appropriate standard of care. A Cavanaugh amendment passed 35-4, as did a similar amendment from the House Health and Human Services Committee on a 38-4 vote.

State Sen. Brian Hardin Gering, chairman of the HHS Committee, opposed LB 933 in committee, but said the added language was an “important clarification.”

“Practitioners are protected by the recommendation itself, but they are responsible for conducting a thorough and appropriate assessment of the patient before making it,” Hardin said.

“Professional malpractice or negligence” is defined in law as failure to use “ordinary and reasonable care, skill and knowledge normally possessed and exercised by members of his profession engaged in similar activities in the same or similar countries.”

In the 2024 general election, 71% of voters supported a recommendation to legalize the possession of 5 ounces of medical cannabis, and 67% of voters created the Nebraska Medical Cannabis Commission.

Reaching 33 votes

Similar protections for providers were included in a bill offering a broader regulatory framework proposed in 2025, LB 677 by state Sen. Ben Hansen of Blair. The bill failed 23-22, missing the 33 votes needed to overcome a filibuster.

Cavanaugh’s LB 933 would also need 33 votes to change voter-approved laws, as required by the Nebraska Constitution.

There is still a way to get there, with 12 senators absent or absent from Friday’s vote. One of them, State Sen. Rick Holdcroft of Bellevue, who was “absent, did not vote,” supported LB 677 10 months ago but did not vote to advance LB 933. He is the only supporter of LB 677 on that ship.

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 this year is being addressed by state budget adjustments LB 1071 and a separate General Affairs bill, LB 1235.

Holdcroft noted that the Medical Cannabis Board has just completed licensing four growers, and indicated that it could be eight months to a year before there is enough of a crop to manufacture and later distribute.

“To start giving immunity to doctors who are going to make recommendations for a product that we won’t even have for a year is, I think, a little premature,” Holdcroft said.

Cavanaugh, Hansen and other advocates say the protections are necessary for a state program to exist. So far, they said, no state doctor has made a recommendation, in part because of fear of retribution, such as from law enforcement. And without protection, supporters worry that there will be no patients able to access board-licensed facilities.

Nebraska Attorney General Mike Hilgers (R) rallied law enforcement against Hansen’s LB 677 in 2025 and spoke out against the health care professionals’ language. His office did not formally oppose LB 933, nor did the Nebraska Department of Health and Human Services.

“The preponderance of scientific evidence”

State Sen. Jared Storm of David City, who led the opposition to LB 677 last year, introduced an amendment to Cavanaugh’s bill requiring the health care professional’s recommendation to be “based on the preponderance of current scientific evidence.”

Storm argued that the “simple and straightforward addition” was rooted in the Hippocratic Oath “to do no harm.”

“If you’re against this amendment, you’re in favor of recreational marijuana,” Storm said. “If you’re in favor of my correction, you see this as medicine.”

Cavanaugh argued the opposite, that LB 933 It would protect advocates and not encourage them to rally in favor of recreational marijuana because of delays in access to medical marijuana. Hansen made a similar request last year.

“If you don’t want a recreational program, we have to make our medical program functional,” Cavanaugh said.

Storm, Hansen and Cavanaugh said they know of no doctors nationwide who have been sued for malpractice or negligence for recommending medicinal cannabis.

‘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 about public safety rather than medical cannabis.

Storer said, “Immunity creates moral hazard. When there are no consequences, there is less incentive to exercise caution.”

Cavanaugh and Hansen were concerned about the long-term effects of Ekaitz’s proposal, arguing that it “muddies the water.” Hansen said we could “go back and bite ourselves in the ass” over some drugs, such as Ivermectin, used in the COVID-19 pandemic.

Cavanaugh said he spoke with the Nebraska Medical Association and the association’s malpractice provider, and Cavanaugh told him that Storm’s amendment would “create more uncertainty.”

Hansen, the former chairman of the HHS Committee, said he understood where Storm was coming from and was aware of Storm’s views on medical cannabis. Hansen said using the “preponderance of scientific evidence” would rule out more than 38 percent of the drugs dispensed off-label.

“I think we’re going down a very dangerous path in the future in terms of micromanaging how a medical professional can prescribe medication in the future,” Hansen said.

‘A bit of fixer upper’

State Sen. Carolyn Bosn of Lincoln, a former prosecutor, clarified with Cavanaugh that nothing in LB 933 would protect a practitioner’s license if it went against their professional judgment. He said the legal standard is based on someone’s education, training and experience. He accepted protections.

Storm said one problem was the difference between a “recommendation” and a “prescription” for medical cannabis. For example, he noted, opioids are tracked under the state’s Prescription Drug Monitoring Program. Hansen proposed using this system in LB 677.

Hardin, who ultimately did not vote on advancing LB 933, said he supported Ekaitz’s amendment. He said they’ve studied marijuana “since they were crossing a mile from my house on the Oregon Trail,” and with dozens of states legalizing marijuana, how to ask that question “in the safest way possible.”

“I think it’s a little bit of a fix, and I think we’re getting there,” Hardin said.

The storm amendment failed 22-19. They may try again at a future debate, as five senators were absent from the state Capitol Friday, including Storer.

‘Small step forward’

Crista Eggers of Nebraskans for Medical Marijuana said she was encouraged by the progress of LB 933, but some of the debate, especially around Storm’s amendment, shows continued opposition to a functioning state program.

“It’s a small step forward today, but we face daunting prospects as this bill moves forward to select file and final reading,” Eggers said after the vote.

“Nebraskas have had few victories in this decades-long battle,” he continued. “Today is one of them.”

LB 933 has two more rounds of debate before it, with 33 votes it can send to Nebraska Governor Jim Pillen for his signature.

Vote to advance bill 933 related to medicinal cannabis

Yes (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*, Terrell*, Margo Juguez*, Margo Juguez McKinney*, Fred Meyer, Glen Meyer*, Jason Prokop*, Dan Quick*, Jane Raybould*, Merv Riepe, Victor Rountree*, Rita Sanders, Ashley Spivey, Brad von Gillern and Dave Wordekemper*.

No (7): Bob Andersen, Rob Clements, Mike Jacobson, Kathleen Kauth, Loren Lippincott, Dave Murman and Jared Storm.

Presented, not voted (7): Christy Armendariz, Beau Ballard, Brian Hardin, Rick Holdcroft*, Teresa Ibach, Mike Moser and Tony Sorrentino.

Sorry, no vote (5): Rob Dover, Bob Hallstrom, Dan Lonowski, Tanya Storer and Paul Strommen.

* Voted in favor of a broader scope of medical cannabis proposed in 2025 (Legislative Bill 677).

This story was first published by the Nebraska Examiner.