Missouri voters are not only considering the legalization of medical marijuana, but they’ll have three General Election ballot measures to do it. 

Amendments 2 and 3 and Proposition C all give voters the choice of legalizing cannabis for medical treatments. Each ballot question varies from the others, though, in the taxation and regulation of the substance. 

What is the difference between an amendment and a proposition? 

A major difference among the three measures is their potential standing in state law books. Both Amendment 2 and 3, if passed, would add a new amendment to the Missouri Constitution. Only another vote by the general public could reverse a constitutional amendment, according to information from the Pettis County Clerk’s Office. 

The same can’t be said for Proposition C. The proposition would only change state statutes, which the Missouri Legislature could alter with a bill passing through the state Senate and House of Representatives. 

Even if Missourians pass Proposition C, state lawmakers could nullify the decision with votes of their own. A statutory change doesn’t command the same legal protections against reversal as a constitutional amendment. 

What if all three measures pass? 

State law outlines which amendment would have the final say in case both Amendment 2 and 3 pass on Nov. 6. If voters pass two or more conflicting amendments in the same election, the measure with the highest number of votes will prevail.

The same section of Missouri’s statutes are unclear whether the winning constitutional amendment would have precedence over Proposition C. 

What is Amendment 2? 

All three measures agree on legalizing the use and sale of marijuana for specified medical purposes. They also support regulating and licensing procedures for marijuana and marijuana facilities, including sale, cultivation, testing and manufacturing of marijuana-infused products. 

That’s about as far as their agreements go. 

Each measure proposes its own tax percentage on retail sale of medical cannabis and has its own ideas for what the tax revenue should support. 

Amendment 2 would impose a 4 percent tax on sales at marijuana dispensaries. The revenue from licensing fees and taxation would go to the Missouri Veterans Commission for care and health services of military veterans. 

The Missouri Department of Health and Senior Services would also receive a share of the revenue to administer the licensing and regulation of marijuana and related facilities. 

This amendment is estimated to generate $18 million each year for state operating costs and veterans’ programs. It would also bring another $6 million annually to local governments. The state would pay an estimated $7 million every year to administer this initiative. 

What is Amendment 3? 

Amendment 3 would impose a larger tax percentage and support a new medical research center with its revenue. 

It would tax retail sales of marijuana at 15 percent and apply another tax on the sale of wholesale marijuana flowers and leaves to licensed facilities. The tax on wholesale flowers and leaves would be based on their weight in dry-weight ounces. 

The funds generated from these taxes would establish and maintain a state research institution for developing cures and treatments for cancer and other incurable diseases. 

The amendment would name Brad Bradshaw, who led the campaign to put Amendment 3 on the ballot, as the chairman of the institute. 

Bradshaw, an attorney and physician from Springfield, would select the members of the board governing the institute, which would determine regulations and licensing procedures for marijuana and medical cannabis facilities. 

State government entities estimate Amendment 3 would cost $186,000 to implement and $500,000 to operate annually. Revenue from the taxation and fees is estimated to generate $66 million each year. 

What is Proposition C? 

Under Proposition C, a written certification from a physician would allow patients to use and possess medical cannabis. The proposition would remove state statutes against medical marijuana for patients with a qualifying medical condition. 

A person’s certification for medical marijuana use would have to come from a physician who treats the diagnosed patient with a qualifying condition. 

It would impose a 2 percent tax on the retail sale of medical marijuana and use the funds for veterans’ services, drug treatment and early childhood education. Tax revenue would also support public safety in cities with a medical marijuana facility. 

Funds from license fees would contribute to the Division of Alcohol and Tobacco Control, under the Missouri Department of Public Safety, to administer the program to license and regulate marijuana and related facilities. 

The state government estimates Proposition C will incur one-time costs of $2.6 million and annual costs of $10 million. In turn, this change in state statute could draw at least $10 million in revenue each year. Local governments would expect no annual costs but could receive at least $152,000 a year. 

What medical conditions qualify for marijuana-based treatment? 

The qualifying conditions for medical marijuana treatments are fairly uniform across all three of the ballot measures. For Amendment 3, the governing board of the created research institute would decide which illnesses could qualify if not already specified in the amendment. 

Patients would be able to use cannabis to treat cancer, epilepsy, glaucoma, any terminal illness, a human immunodeficiency virus or an acquired immune deficiency syndrome.

The state would allow medical marijuana for a chronic condition that causes persistent pain or muscle spasms, such as multiple sclerosis, seizures, Parkinson’s disease and Tourette’s syndrome. 

Patients diagnosed by a state-licensed psychiatrist with a debilitating psychiatric disorder would also qualify. This includes, but isn’t limited to, post-traumatic stress disorder. 

Some conditions would fall to a physician’s discretion as to whether to prescribe medical marijuana treatments. For example, a doctor could prescribe cannabis for intractable migraines that are unresponsive to other treatments. 

A physician could also determine whether marijuana is a fit alternative for a chronic medical condition normally treated with a prescription medication that could become addictive. Doctors would be allowed to decide whether medical use of marijuana could be effective in treating that condition and whether it would serve as a safer alternative to a prescription medication. 

Similar rules would apply for any other chronic, debilitating medical conditions, such as hepatitis C, Crohn’s disease, autism or Alzheimer’s disease.

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