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Everything You Need To Know About Missouri’s 3 Competing Medical Marijuana Ballot Initiatives

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Missouri will have three different medical marijuana initiatives to choose from on the upcoming November ballot. If you’re feeling a little overwhelmed by all those options, don’t sweat it. Civilized has put together a handy little guide on what you need to know about Missouri’s Amendment 2, Amendment 3 and Proposition C.

What’s the Same?

There are a lot of similarities between the three ballot initiatives that Missourians will vote on. If passed, each of them would allow patients with qualifying conditions to access medical marijuana when recommended by a physician. Patients would be allowed to buy cannabis flower and extracts for smoking or vaping, edibles, balms, transdermal patches and suppositories. Physicians will also be able to recommend other consumption methods.

The following list of qualifying conditions is essentially the same across the three initiatives as well:

Now here are some of the key differences among the competing initiatives.

Amendment 2

Amendment 2 would legalize medical marijuana in Missouri via a constitutional amendment. That would make the initiative both harder to pass but also harder to repeal down the road. Amendment 2 needs to get approval from at least 55 percent of voters in order to become part of the Missouri constitution. But if it hits that mark, then it can’t be changed without another vote from the people. So anti-cannabis lawmakers wouldn’t be able to dismantle the bill in the legislature.

New Approaches Missouri is leading the campaign in support of Amendment 2, which they say offers a better tax system than the other ballot initiatives. 

Amendment 2 levies a reasonable tax rate of 4 percent on medical marijuana sales and the revenue generated funds veterans’ services in the state,” a spokesperson for New Approaches Missouri told Ballotpedia. This funding mechanism is supported by patients, veterans and the healthcare community. Amendment 3 has an exploitive 15 percent sales tax, the highest medical marijuana tax in the nation, directed to the new research institute. It’s simply wrong to put a tax that high on medicine at the expense of patients with cancer and other debilitating illnesses.”

How Much Medical Marijuana Can You Have?

Under Amendment 2, patients would be able to buy and possess no less than 4 ounces of dried cannabis or equivalent at a time within a 30-day period. That’s one ounce more than Amendment 3’s minimum, but slightly less than Proposition 3’s regs, which would allow patients to have 2.5 ounces per 14-day period (so roughly 5 ounces per month).

Amendment 2 is also the only medical marijuana initiative on the Missouri ballot that would allow for home cultivation. Patients would be allowed to grow up to 6 flowering plants, which can help them cut down on the costs of getting their medicine.

Where Can You Get Medical Marijuana?

Amendment 2 would require that there are at least 24 dispensaries in each of Missouri’s 8 congressional districts.

Local governments would not be allowed to ban dispensaries from operating within their jurisdiction. However, they can stipulate where dispensaries and other cannabis-related facilities are allowed to operate in their area.

Who’s in Charge and Where Does the Money Go?

Amendment 2 would see the existing Missouri Department of Health and Senior Services as the regulating body for medical marijuana. 

Taxes collected from cannabis sales would be distributed to various veteran-directed services, including healthcare, housing assistance and job training.

Amendment 3

Amendment 3 is the other of the two initiatives on the upcoming ballot that would legalize medical marijuana in Missouri via a constitutional amendment. It too will need a 55 percent majority to pass and can’t be changed without another vote from the people.

Find the Cures is leading the campaign in support of Amendment 3.

How Much Medical Marijuana Can You Have?

Under Amendment 3, patients will be able to buy at least 3 ounces of dried cannabis or equivalent within a 30-day period. That’s 1 ounce less than the guaranteed minimum included in Amendment 2, and 2 ounces less than Proposition 3’s minimum limit. 

Where Can You Get Medical Marijuana?

Amendment 3 requires at least one dispensary for every 10,000 residents of a city or county. So take the total population of Missouri, divide it by 10,000 and you’ll get roughly 611 stores to cover the state’s population of just over 6 million residents. That’s a lot more than the 192 dispensaries promised under Amendment 2.

But it might be hard to hit that 611 mark since Amendment 3 also allows local governments to block dispensaries from operating within their jurisdiction if a majority of voters support the ban.

Who’s in Charge and Where’s the Money Go?

If Amendment 3 is passed, it would create a new Biomedical Research and Drug Development Institute to oversee medical marijuana regulation.

Cannabis sales would be taxed at a rate of 15 percent and revenues would be directed back to the Biomedical Research and Drug Development Institute to help fund cancer research. That tax rate is 11 percent higher than Amendment 2’s rate and 13 percent higher that Proposition 3’s tax scheme.

But the Find the Cures campaign says those expenditures will actually create jobs in the state and turn Missouri into a global leader in cancer research. A spokesperson told Ballotpedia that the tax rate should raise approximately “$66 million annually for Cancer and Disease Research. Each direct dollar will generate up to 4 additional matching dollars annually, bringing the annual total to upwards of $330 million to cure cancer and other diseases. Missouri will become a world leader in medical research. An estimated 10,000+ new high paying jobs will be created.”

And Missouri residents will also reap the fiscal benefits of that research because 50 percent of the money generated from the research institute must be given back to Missouri residents in the form of an annual income tax refund,” according to the spokesperson.


There are a few minor differences in Amendment 3’s qualifying conditions list. Amendment 3 is the only initiative that explicitly lists MS as a qualifying condition. In most cases, however, MS would fall within the conditions causing chronic pain/​muscle spasms’ category that the other two initiatives have listed in their qualify conditions.

Additionally, Amendment 3 has end stages illnesses’ listed on their list of qualifying conditions, a term that is largely synonymous with terminal illnesses.

Proposition C

Proposition C is the only initiative on Missouri’s November ballot that would legalize medical marijuana in the state via a new law. It will need a simple 50 percent majority in order to pass. If successful, state lawmakers will be able to revise it as they see fit.

Missourians for Patient Care is leading the campaign in support of Proposition C.

How Much Medical Marijuana Can You Have?

Under Proposition C, patients will be able to buy at least 2.5 ounces of dried cannabis or equivalent within a 14-day period. Patients will be allowed to possess up to a 60-day supply of dried cannabis or equivalent, but home cultivation will remain prohibited.

Where Can You Get Medical Marijuana?

Proposition C requires at least one dispensary for every 100,000 state residents. So roughly 61 dispensaries, which is roughly one-third of the number of shops allowed under Amendment 2 and one-tenth of the number of retailers permitted under Amendment 3.

With a two-thirds vote, local governments can block dispensaries from operating within their jurisdiction under Proposition C.

Who’s in Charge and Where’s the Money Go?

Proposition C would make medical marijuana regulation a joint effort between the the existing Missouri Department of Health and Senior Services and Division of Alcohol and Tobacco Control.

The initiative would impose a 2 percent tax on cannabis sales. That’s half the rate under under Amendment 2 and 13 percent cheaper than Amendment’s 3’s suggested rate. That rate is essential to making medical marijuana both accessible and affordable to patients who need it.

This low retail tax rate lowers the burden of cost on patients accessing medical cannabis,” a spokesperson from Missourians for Patient Care told Ballotpedia. It is the only measure that funds all drug treatment facilities in the state, regardless of drug addiction. Funds would also support veterans’ services, public safety, and early childhood education and development.”

Money raised through the cannabis tax would be allocated to veterans’ services, drug treatment, education, and law enforcement.

Which One Should You Pick?

All three initiatives have the same overall goal in mind: providing patients with access to medical marijuana. So to figure out which one you like best, you have to weigh the different regs against each other. And if you’re still not sure after that, then the best thing to do would be to vote for all three, according to Mason Tvert — Media Relations Director for the Marijuana Policy Project.

We certainly would encourage anyone who isn’t sure to simply vote yes on all three to ensure that at least one medical marijuana initiative passes,” Tvert told Civilized. Any of them are better than nothing. We [at MPP] have specifically endorsed one of the three measures — Amendment 2 — and are encouraging voters to support it. But we think it would be best for people to vote for all of them instead of none of them.”

If Amendment 2 and Amendment 3 pass, then the one that received the most support from voters will be adopted into the competition. But if Proposition C passes as well, then the courts would have to decide how to reconcile the two competing initiatives. But whatever the judge decides, passing these initiatives would still be a huge win for patients in Missouri.


Recent polling doesn’t show any clear winner between the three initiatives. However, 54 percent of Missourians say they plan to vote for medical marijuana in general, and only 35 percent said they were against. So it seems likely that one or perhaps all three ballot initiatives will pass.

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