On April 20, 2026 (yes, that 420), United States Senator Ted Budd of North Carolina introduced the Marijuana Impact on Medicaid Act.
Pause on the date. Pause on the name.
The bill, co-sponsored by Senator Pete Ricketts of Nebraska, directs HHS to collect data on Medicaid spending “attributable to costs incurred for providing medical assistance for inpatient hospital services, outpatient hospital services, and for services received at a hospital emergency room… related to marijuana use (as defined by the Secretary).” HHS then reports to Congress within a year with “any recommendations for legislation or administrative action as the Secretary determines appropriate,” quoting the bill verbatim.
Read those two parentheticals again. They are doing all the work.
“Marijuana use (as defined by the Secretary).” “Recommendations… as the Secretary determines appropriate.” The bill hands the very definition of what it’s measuring, plus the policy conclusion drawn from that measurement, to whoever happens to be running HHS that week. A friendly Secretary could read “marijuana-related” to mean documented acute toxicity, full stop. A hostile one could stretch it to cover any ER admission where the patient tested positive for THC metabolites in the prior 30 days. Or 60. Or 90. The Secretary picks. Same statute, completely different universe of numbers.
The substantive section of the Marijuana Impact on Medicaid Act is 22 lines long. There is no funding for the data collection. No methodology. No comparison cohort. No requirement that findings be peer-reviewed or even reviewed at all before “recommendations” arrive on Capitol Hill. The bill is, structurally, a request for a number, and a license for whoever generates the number to also generate the policy that follows from it.
The Marijuana Impact on Medicaid Act is supported by exactly one organization: Smart Approaches to Marijuana, the prohibitionist group co-founded in 2013 by Kevin A. Sabet and former Congressman Patrick J. Kennedy. Sabet himself is quoted in Budd’s release, calling the accounting “long overdue.” Senator Ricketts, in his own quote, helpfully volunteers that “the average THC potency in marijuana has more than tripled since 1995,” a SAM talking point that has been recycled, almost verbatim, for the better part of a decade.
The Op-Ed That Wrote Itself
On April 20, 2026 (same day, same 4/20), Compact magazine published an essay by Kevin Sabet titled “The Marijuana Backlash Is Here.” Author bio, verbatim: “Kevin Sabet is president and CEO of Smart Approaches to Marijuana.” The essay is a long indictment of commercialized cannabis, marshaling studies, statistics, and the 2021 suicide of a young man in Colorado to argue that America is finally turning against legal weed. Sabet’s own framing, from near the essay’s close: “That a backlash has begun seems hard to deny.” A useful line, coming from the man running the public-relations apparatus that helps generate them.
So to recap the day:
Morning. Senator Budd introduces a bill and cites SAM as its endorser. Afternoon. SAM’s CEO publishes an op-ed declaring that the backlash he is professionally paid to produce is now an emergent national phenomenon. Evening. The story gets covered as if these were two separate developments.
This isn’t a backlash. It’s a rollout, paid for in advance.
Real backlash happens on its own clock. They don’t arrive with a co-signed press release dropped at 9 AM EST. Call the wave you generated “the tide” loud enough, and nobody asks who paid for the buckets.
The Real Conversation, Not This One
Here’s the part where we tell you the truth: there are real concerns buried inside the Sabet op-ed. We’re not going to pretend otherwise.
Youth access matters. So do high-potency concentrates. So does copycat packaging that looks like children’s candy, and no serious person in the New York industry thinks a “Stoney Patch Kids” knockoff belongs in a regulated store. OCM banned that whole category in licensed shops some time back, and we agreed with the call. The science on adolescent brains and cannabis is still being written, and anyone telling you it’s settled in either direction is selling something. Commercializing a psychoactive substance? That should make everyone nervous. Ask anyone who watched Big Alcohol get a century-long head start on common sense.
But Budd’s bill does not address any of that.
Youth prevention? Not funded. Potency caps? Nope. Packaging, ads, labeling? Not in here. Interstate commerce, testing labs, the illicit market that still dwarfs legal sales in most states? Same answer. What the bill actually does is request a number from HHS. The press release has already told you what the number will mean. The number, once produced, can then be cited in the next press release. Talking-point laundering, basically.
What the “Backlash” Story Leaves Out
Five years into the Marihuana Regulation and Taxation Act, here’s what New York has actually built. Three billion dollars in legal adult-use sales. More than 623 licensed dispensaries are open statewide. Tax revenue funneled into community reinvestment in the same neighborhoods the drug war hollowed out for decades. (Yes, the drug war SAM keeps trying to get a sequel of.) OCM caps doses on edibles, requires testing, mandates labeling, and gives licensing preference to the people prohibition spent decades putting through the system. As of the April Cannabis Control Board meeting, 56 percent of all adult-use licenses have gone to social and economic equity applicants. The state has dragged unlicensed shops into court after they spent two years pretending to be legitimate. That’s not a runaway industry. That’s a market being built in public, in real time, with guardrails.
Criticize the rollout if you want. Plenty of licensed operators do, loudly and often, and they’re usually right. The dishonest move is calling legalization “chaos” while pretending the previous quarter-century, the one with mass incarceration, multibillion-dollar illicit markets, and zero youth-access guardrails worth the name, was the orderly version.
The Name on the Door
The senator’s surname is, yes, Budd. We acknowledge the irony and move on: too many actual people downstream for the joke to matter. Patients. Consumers. Farmers. Budtenders. Chemists. Small-business owners. Millions of them, trying to build a regulated industry out of the wreckage of a 90-year drug war. What they could use from Congress is a sober conversation about what this industry should look like: potency standards, youth access, packaging, taxation, and public health outcomes. None of which is anywhere in the bill on the table.
What they got on April 20 was a manufactured news cycle. A bill. A blog post. A brand.
Call it what it is. Then get back to the real work.
