The Risky Gambit: Trump's Cannabis Reclassification and Medicare CBD Proposal

Introduction and Context

In a move that could reshape both the healthcare landscape and the cannabis industry, President Donald Trump is reportedly preparing to sign an executive order that would dramatically alter federal cannabis policy. The proposal involves two significant changes: reclassifying cannabis from Schedule I to Schedule III under the Drug Enforcement Administration’s controlled substances list and authorizing a pilot program allowing Medicare to cover cannabis-derived products, particularly CBD, for senior citizens. This would place cannabis alongside drugs like Tylenol with codeine rather than its current classification alongside heroin and LSD.

The context for this policy shift is increasingly relevant as cannabis use patterns evolve nationwide. A 2024 study revealed that more Americans now report daily or near-daily marijuana use than report drinking alcohol with the same frequency—the first time in 40 years of data collection that cannabis has outpaced alcohol in daily use metrics. Meanwhile, 25 states and the District of Columbia have legalized recreational cannabis, creating a patchwork of state-level regulations that conflict with federal prohibition.

The Proposed Policy Framework

According to industry insiders and cannabis advocates who spoke with CNBC, the executive order would specifically target cannabidiol (CBD) products aimed at treating chronic pain, sleep deprivation, and other age-related ailments. Shawn Hauser, a partner at cannabis-focused law firm Vicente LLP, anticipates the order will clarify which cannabinoids are covered and require they come from federally legal sources. The Medicare pilot program would represent a significant departure from current practice, as the Food and Drug Administration has so far only approved one CBD-based drug, Epidiolex, for treating rare forms of epilepsy.

The economic implications are substantial. Timothy Seymour, founder of Seymour Asset Management, predicts that rescheduling combined with Medicare coverage could “double or triple” the cannabis sector’s valuation by attracting institutional investors previously hesitant to engage with Schedule I substances. Stocks of major cannabis companies like Tilray Brands and Canopy Growth already surged 44% and 52% respectively on recent rumors of these changes.

The Driving Forces Behind the Proposal

The Medicare initiative appears to be championed by billionaire Howard Kessler, a financier and longtime Trump ally who founded The Commonwealth Project in 2019 to advocate for senior care including through cannabis use. Kessler and his advocates have urged the administration to bypass typical FDA hurdles—such as years-long clinical trials—in favor of a pilot program gathering real-world data on cannabinoid safety and outcomes in the senior population. This approach has found favor with the president, who shared a Commonwealth Project video on Truth Social branding CBD coverage as “the most important senior health initiative of the century.”

However, the proposal faces significant opposition even within Trump’s political circle. House Speaker Mike Johnson has raised concerns about the program’s cost and liability, while FDA officials argue that reimbursing Americans for non-agency-approved treatments would be unprecedented. The scientific community remains deeply divided on the medical efficacy of cannabis for the conditions targeted by the proposal.

A Dangerous Departure from Evidence-Based Medicine

As a firm believer in democratic institutions and scientific integrity, I view this proposed policy with profound concern. While the reclassification of cannabis from Schedule I may have merit for facilitating research, the Medicare pilot program represents a reckless abandonment of evidence-based medicine that could endanger vulnerable seniors. The approach of bypassing rigorous clinical trials in favor of “real-world data” collection on Medicare beneficiaries is particularly alarming given the demographic’s susceptibility to medication interactions and adverse effects.

Meg Haney, director of the Cannabis Research Laboratory at Columbia University, rightly characterizes this proposal as “egregious” and notes that “it’s not at all based on science. This is all based on money.” Her assessment underscores the dangerous precedent being set: allowing political connections and financial interests to dictate medical policy rather than scientific evidence. The fact that Howard Kessler, a Trump ally with potential financial interests in the outcome, appears to be driving this initiative should raise red flags for anyone committed to transparent, ethical governance.

The Hypocrisy of Selective Deregulation

What makes this proposal particularly troubling is its selective approach to deregulation. While claiming to embrace cannabis access, the administration would maintain federal control over which products qualify—creating a system where politically connected operators benefit while smaller businesses struggle. The potential migration of distribution from state-licensed dispensaries to national pharmacy chains like CVS and Walgreens could crush small entrepreneurs while enriching large pharmaceutical companies that have the resources to navigate the remaining regulatory hurdles.

This creates a perverse situation where the administration talks about expanding access while potentially creating new barriers for all but the best-connected players. The promise of research expansion rings hollow when the same proposal undermines the very scientific processes that would produce reliable data. If we genuinely want to understand cannabis’s medical potential, we should fund proper clinical trials through established scientific channels rather than experimenting on Medicare beneficiaries with insufficient safeguards.

The Elderly: Vulnerable Subjects in a Dangerous Experiment

Senior citizens represent one of our most vulnerable populations, often managing multiple chronic conditions and taking numerous medications that could interact dangerously with cannabis products. A recent FDA-funded study suggested that prolonged CBD use may cause liver toxicity and interfere with other life-saving medications. A 2023 review of 134 studies involving adults over 50 found medical cannabis had inconsistent outcomes for conditions like end-stage cancer and dementia while showing more frequent links to harms including depression, anxiety, cognitive impairment, and injury.

Using our elderly population as test subjects for a substance with such uncertain safety profiles—without the rigorous oversight of clinical trials—is ethically questionable at best and potentially dangerous at worst. The compassionate impulse to relieve suffering is understandable, but it must be balanced against the principle of “first, do no harm.” We owe our seniors treatments that have been properly vetted through scientific processes, not politically connected shortcuts.

The Proper Path Forward

If the administration genuinely wants to expand cannabis research and access, there are responsible ways to accomplish this goal. First, rescheduling cannabis to facilitate research is a reasonable step that should be taken independently of the Medicare proposal. Second, we should significantly increase funding for properly designed clinical trials through the NIH and other research institutions to build the evidence base we currently lack. Third, any expansion of Medicare coverage should follow—not precede—thorough scientific review and FDA approval processes.

The current approach puts the cart before the horse in a way that prioritizes political expediency and financial gain over patient safety. Ryan Vandrey of Johns Hopkins University correctly notes that “without [proper] data, policymakers are being asked to make decisions in the dark.” We should be illuminating that darkness with rigorous science, not plunging ahead based on the influence of wealthy allies and industry lobbyists.

Conclusion: Upholding Principles Over Politics

As defenders of democratic institutions and evidence-based policymaking, we must reject this dangerous approach to cannabis policy. The potential benefits of cannabis research and medical application are too important to be hijacked by political connections and financial interests. We need policies that prioritize patient safety, scientific integrity, and transparent processes over backroom deals and industry lobbying.

The proposed executive order represents a betrayal of the principles that should guide healthcare policy in a democratic society. It threatens to undermine the FDA’s scientific authority, endanger vulnerable seniors, and create a system where political connections rather than medical evidence determine treatment options. We must demand better from our leaders—policies grounded in science, developed through transparent processes, and focused on patient welfare rather than political advantage or financial gain.

Our commitment to freedom and liberty must include the freedom to access treatments that are both effective and safe, backed by rigorous science rather than political convenience. This proposal fails that fundamental test, and we should reject it accordingly while advocating for a more responsible path toward understanding and potentially utilizing cannabis’s medical potential.