Trump green-lights these "no charge" marijuana products for Medicare enrollees

Driving the news: Marijuana use among older adults in the U.S. is growing fast.

• In 2023, 7% of adults aged 65 or older reported that they had used it in the past month, per an NYU study published this summer.
• That's up from 4.8% in 2021 and 5.2% in 2022 — a nearly 46% increase in just two years.

Catch up quick: The executive order reclassifies marijuana as a Schedule III drug under the U.S. Drug Enforcement Agency in addition to authorizing the Medicare pilot.

• The reclassification puts cannabis in a category with Tylenol with codeine, rather than with Schedule I drugs such as heroin and LSD.
• It also authorizes Medicare to fully cover CBD products for patients.

What they're saying: "The facts compel the federal government to recognize that marijuana can be legitimate in terms of medical applications when carefully administered," Trump said.

• He added that such applications include substituting marijuana for "addictive" and "potentially lethal" opiates.

The Centers for Medicare & Medicaid Services (CMS) did not immediately respond to Axios' request for comment.

Here's what we know about a pilot program for Medicare to cover cannabis:

What the order means for seniors, Medicare

The fine print: Medicare will specifically only cover cannabidiol products, or CBD.

• Coverage will start "as early as April of next year at no charge, if their doctors recommend them," CMS administrator Mehmet Oz said at the signing.

The Department of Health & Human Services (HHS) has recently indicated an openness to loosening cannabis product restrictions.

• The CMS published a proposed rule change in the Federal Register last month that would authorize insurance coverage for CBD products under Medicare Advantage programs.
• HHS Secretary Robert F. Kennedy Jr. has previously supported decriminalizing cannabis.

What we're watching: Oz said that Medicare Advantage insurers are "also agreeing to consider CBD to be used for the 34 million Americans that they cover."

• Oz added that if the change "shows promise," CMS will "expand access to these products to even more conditions," and to Medicaid beneficiaries as well.

Flashback: Trump in September posted a video on Truth Social which advocated for Medicare coverage for CBD.

Medical uses for CBD

"We need more research, but CBD is proving to be a helpful, relatively nontoxic option for managing anxiety, insomnia, and chronic pain," Peter Grinspoon, a physician and instructor at Harvard Medical School, wrote last year.

Yes, but: Long-term CBD use could cause liver toxicity, according to a recent study funded by the Food and Drug Administration (FDA).

• Research also shows it can interfere with other medications, and poses some risks to male reproductive health and pregnant people.

What advocates say about the pilot

A Medicare pilot program "offers a real glimpse of what's possible when federal policy begins to acknowledge medical reality," said Steph Sherer, president of Americans for Safe Access, a nonprofit that advocates for legal access to cannabis for therapeutic use and research.

• Sherer cited the HHS' 2023 recommendation that marijuana be reclassified from Schedule I to Schedule III.
• That recommendation "should be opening doors across the healthcare system," she said. "This CMS proposal may be the first crack in that wall."

Don Williams, chair of the New York Medical Cannabis Industry Association, told Axios it makes sense for the insurance industry to include coverage for cannabinoid-based therapies that specifically address age-related conditions.

• "These therapies are often cheaper and less harmful than many of the pharmaceuticals used presently."

The other side: Others were cautious about around CBD at the expense of THC, or even doing more research into CBD.

• Jordan Tishler, president of the Association of Cannabinoid Specialists, called the Medicare proposal "grandstanding at best."
• "While we applaud the concept of making cannabinoid medications available and covered by insurance, the current idea would only cover certain cannabinoids that have very little human data to support them, while not covering THC for which there are decades of good human research."
• There's "great evidence for the safety and efficacy of THC" and a "lack of evidence to support other cannabinoids at this time," said Tishler, who is also an instructor at Harvard Medical School.

Go deeper: Trump signals marijuana pivot. Here's how federal and state cannabis laws work