Nebraska’s medical cannabis program is moving from voter authorization into implementation. In November 2024, about 71% of voters supported legalization for qualified patients and 67% backed a regulatory system, according to Ballotpedia. The state Supreme Court later unanimously rejected a challenge to the petition signatures, finding that challengers had not shown enough signatures were invalid to disqualify the initiatives, according to KLIN.
The rules limit what can reach patients
The state’s regulatory system has a gap at the testing stage: the Nebraska Medical Cannabis Commission has no authority under state law to license or oversee testing facilities, the Nebraska Examiner reported. State rules also exclude raw flower, edibles, and products intended for smoking or vaping. Permitted forms include tablets, capsules, tinctures, gels, oils and topicals, according to MJBizDaily.
Who may qualify for treatment
Nebraska law defines an adult qualified patient as someone with a health care practitioner’s written recommendation; a minor also needs written permission from a parent or legal guardian with authority to make health care decisions. The recommendation must be a signed, dated declaration that the practitioner judges cannabis’s potential benefits outweigh its potential harms for alleviating a medical condition, its symptoms, or side effects of treatment. It is valid for two years unless the practitioner specifies another period, according to the Nebraska Legislature.
The program’s next steps for growers depend on testing and processing capacity that is not yet in place: biomass must be tested and turned into an allowed product, but Nebraska has no licensed product manufacturers or transporters. MahāMotā Cultivation Co., the first licensed cultivator nearing harvest, told commissioners its crop was about four to six weeks from harvest and that it had no pathway to testing. The company’s cultivation systems manager, Garrett Elting, said storage could last for months and product quality could decline during that time, the Examiner reported.
The rules also limit how many businesses can fill those roles. Nebraska’s regulations cap the program at four cultivators, four product manufacturers and 12 dispensaries, according to MJBizDaily. Those caps, combined with the restrictions on product forms, leave few potential in-state routes for a harvest to move through testing and processing.
How other states approach testing
Iowa’s Office of Medical Cannabidiol describes testing at two points in production: cannabis extracts are tested before formulation, and finished package lots are tested before delivery to dispensaries. Its 2020 guidance says extract testing includes checks for pesticides, residual solvents and heavy metals. The comparison describes Iowa’s testing process; it does not mean Iowa and Nebraska have equivalent rules, according to the Iowa Department of Public Health’s Office of Medical Cannabidiol. A recent Missouri recall notice offers another example of testing’s role: on September 16, 2026, the state said routine testing found Aspergillus in Juicy J’s cherry-limeade infused pre-rolls. The recall concerned a finished product and does not indicate that Nebraska’s crop is contaminated, according to the Missouri Department of Health and Senior Services, Division of Cannabis Regulation.
Licensing depends on pending fees
A proposed fee schedule is one step in the commission’s licensing process, which depends on approval of proposed regulations, according to the Nebraska Examiner. The commission scheduled a public hearing on the fees for Thursday at 1 p.m. in Lincoln. The proposal includes a $5,000 application fee, annual license and renewal fees that vary by license type, and a $13,000 annual fee for each licensee’s participation in the state’s seed-to-sale tracking system. The commission’s next regular meeting is set for October 19 at 1 p.m. in Lincoln.
The Legislature did not change the voter-approved cannabis laws during the two sessions after the 2024 vote, but lawmakers authorized fees in April and provided the commission additional funding that month. That funding allowed the agency to hire staff and obtain office space. Temporary regulations adopted by the commission have since become permanent, the Examiner reported.
The agency is still building capacity
The commission began work in June 2025 and licensed its first cultivators in early October that year. Two commissioners resigned in September 2025 after the federal indictment of the former Nebraska Liquor Control Commission director; the two commissioners were not implicated in the indictment. Jim Elworth and Bud Synhorst filled the vacancies in November. Commission chair Dr. Monica Oldenburg resigned in February 2026, and Gov. Jim Pillen has not appointed a replacement, according to the Examiner.
Last month, the commission hired Brett Long as its first executive director. Long previously worked at the Nebraska Department of Revenue, including in charitable and skilled gaming services, and at the Nebraska Department of Health and Human Services on behavioral health and substance use initiatives. Interim chair Lorelle Mueting said his regulatory and state government experience suited the role, the Examiner reported.
Advocates continue to press commissioners to speed up the program. Crista Eggers, who leads Nebraskans for Medical Marijuana, said she had spent about a decade advocating at the Legislature and that the group had petitioned for a ballot measure for more than 2,500 days. Eggers also described the delays as especially distressing for families whose children could benefit from medical cannabis, and said they felt intentional, the Examiner reported.
