Do you have to be dying to receive treatment? The project that expels 66,000 patients in Puerto Rico

G9 warns that PC 1281 could leave *66,000 patients** without medicinal cannabis.

The measure maintains the requirement that disabling conditions be linked to a terminal illness.

San Juan, Puerto Rico; the G9 Alliance called for stopping the advancement of House Bill 1281 and holding public hearings before the Legislative Assembly votes on the measure. The Committee on Government recommended approving the bill with amendments that preserve a central restriction: only patients with terminal conditions or with disabling conditions directly associated with those terminal illnesses would qualify.

The committee report, dated October 14, includes opposition from the Department of Health and the Cannabis Medicinal Regulatory Board. Health estimates that about 66,000 of the 108,253 patients registered as of December 17, 2025 could lose eligibility if the measure becomes law.

The proposal would amend the MEDICINAL Law and limit access for patients who currently receive cannabis as a palliative treatment for disabling conditions. The Board defines medicinal cannabis as a therapeutic alternative for certain conditions that affect patients’ health and quality of life.[1]

Patients question the requirement for a terminal condition. Madeline Rivera Feliciano, a patient with multiple sclerosis, submitted a written statement to the Commission. In her testimony, she explained that medicinal cannabis has helped her manage her condition and regain her quality of life.

“I shouldn’t have to be dying for my access to a treatment that helps me live to be respected,” Rivera Feliciano said.

The patient asked representatives to listen to the people who depend on the program before approving changes that could affect their treatments.

Her complaint raises a central question for public policy: should a person lose access to a palliative treatment because their illness isn’t terminal? In other words, do they have to be dying to want quality of life?

G9 questions the Committee’s recommendation, noting that José Aleczer Rivera, executive director of G9 Alliance, said the committee included warnings from the Department of Health and the Cannabis Medicinal Regulatory Board in its report, but still recommended keeping the restriction.

G9 Alliance, which groups licensed medicinal cannabis operators in Puerto Rico, argues that the bill does not correct the program. It reduces the number of patients who can access it.

Protections for applications and renewals submitted before the law’s entry into effect would also not solve the problem in the long term. According to G9, those provisions do not guarantee the permanent eligibility of current patients or their future renewals.

Federal changes create a different situation for Puerto Rico, especially since the controversy arises while the U.S. federal government relaxed the classification of certain medicinal cannabis categories.

An order published in April 2026 placed on Schedule III cannabis products approved by the Food and Drug Administration (FDA) and medicinal cannabis subject to state licenses.

G9’s position is that Puerto Rico should strengthen its regulated program to respond to this new framework, rather than reducing the number of patients who can access authorized products.

“Puerto Rico cannot respond to the recognition of cannabis’s medical use by closing the door to those who need treatment,” Rivera said.

G9 also warned that a significant reduction in patients could weaken licensed cultivation sites, manufacturers, and dispensaries. In its view, fewer patients could lower revenues in the regulated system and push some people toward products outside license controls, traceability, and oversight.

“The bill would also have an economic impact.”

The Legislative Assembly’s Office of Budget estimated a maximum potential fiscal impact of approximately $53 million per year under a “upper-bound” scenario.

The figure does not represent a guaranteed loss, but it indicates the possible effect of significantly reducing the eligible population.[9]

The analysis also considers losses to public programs and services tied to medicinal cannabis revenues. The Legislative Assembly must examine that scenario before making a final decision.

For G9, the debate should not be limited to the number of registered patients or the program’s income. The discussion should include the continued availability of treatments, medical supervision, and the stability of the regulated system.

“G9 calls for public hearings and changes to the bill.”

G9 Alliance urged the House to:

• Hold public hearings before approving PC 1281.

• Listen to patients with disabling conditions.

• Assess the projected impact on about 66,000 patients.

• Review the Office of Budget’s fiscal analysis.

• Remove the requirement that the disabling condition be associated with a terminal illness.

• Keep measures for research, education, enforcement, and medical oversight.

“If there are shortcomings, let’s identify them and correct them with evidence. Listen to the patients, hold public hearings, and remove the terminal-illness restriction,” Rivera concluded.

The Legislative Assembly’s decision will determine whether the program continues to serve patients with disabling conditions or whether access will be concentrated in people with terminal diagnoses.

For those who rely on medicinal cannabis, the legislative debate may decide whether they keep a treatment that is already part of their daily management.

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References:

[1] PC 1281 – Para enmendar los Artículos 2,3,5, 10, 11, 12, 13, 14, 15… www.legislapr.com

[2]EE.UU. flexibiliza la clasificación de ciertos productos de cannabis medicinal… - www.allende.com

[3]Estatus legal del consumo de cannabis en el mundo - es.wkipedia.org

[4]Marihuana: algunos productos reclasificados en la Lista III - www.foley.com

[5]Junta Reglamentadora del Cannabis Medicinal – www.salud.pr.gov

[6]Reguladores de cannabis estatales dejados sin orientación después de… -www.mycannabis.com

[7]California DCC facilita el cambio de licencia médica a medida que entra… - www.mycannabis.com

[8]Semillas de cannabis: las búsquedas suben un 40% en 2026 – www.thecannex.com

[9]Puerto Rico calcula el costo de restringir el cannabis medicinal | Cáñamo… - www.canamo.net

[10] EL DOJ reclasifica el cannabis a la Lista III: lo que significa para la… - www.sensculture.com