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Millions of Americans have used medical marijuana. Is it covered by their FSAs?

Emma Burleigh
By
Emma Burleigh
Emma Burleigh
Reporter, Success
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Emma Burleigh
By
Emma Burleigh
Emma Burleigh
Reporter, Success
Down Arrow Button Icon
April 19, 2024, 8:26 AM ET
A pharmacist assists a customer with medical marijuana.
Over 8 million Americans use medical cannabis, but can't apply it to their FSAs. Getty Images
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Tomorrow marks an unofficial holiday celebrated by marijuana users across the U.S.: April 20, more commonly known as 4/20. 

Once a fringe substance, weed is now mainstream, and millions of Americans use it to treat a host of medical ailments including chronic pain and nausea. Currently, 24 U.S. states have legalized overall consumption of weed, and another 14 states allow medicinal use, according to a recent report from the Pew Research Center. Around 2.5% of U.S. adults, or 8.3 million people, said they have used marijuana under their physician’s authorization, according to 2020 research from the American Journal of Preventive Medicine (AJPM). 

But for those who partake legally and medicinally, one question remains: do flexible spending accounts, or FSAs, cover cannabis? 

FSAs are an arrangement in which employees can set aside up to $3,200 of their pre-tax income annually to pay for out-of-pocket medical costs. That money can be used for healthcare expenses like deductibles, copayments, and qualifiable prescription drugs. What exactly qualifies as a medical expense isn’t always clear, but one thing’s for sure: Marijuana does not. 

“The issue with medical marijuana is it’s still considered a schedule one drug,” Paul Fronstin, director of health benefits research at Employee Benefit Research Institute (EBRI), a nonprofit organization, tells Fortune. That puts it in the same federal category as LSD and ecstasy. “So since it’s technically not a legal drug under federal law, you can’t use an FSA to get reimbursed for medical marijuana.”

Even if the federal government does legalize marijuana at some point, it’s still uncertain whether companies would allow workers to charge medical cannabis toward their FSA spending, according to Fronstin. Employers have the right to choose what they cover under the purview of qualified medical benefits not included in traditional healthcare plans—and the fuzziness around exactly how and why employees are using marijuana might prove too much for some companies.    

“Employers may just say, ‘You can’t use any marijuana because we don’t want to deal with having to distinguish between medical and recreational,’” he says. 

Although FSA coverage for medical cannabis may be a lost cause for now, it could potentially be covered as an employee benefit through lifestyle spending—employer-funded accounts with money set aside for workers to spend at their discretion. And as American weed usage continues to trend upwards, more workers may value companies that subsidize marijuana over those that don’t. 

“As these lifestyle spending accounts become more popular, employers are looking for different ways to benefit employees,” Wade Symons, regulatory resource group leader at Mercer, an HR consulting firm, tells Fortune. But he adds that that hesitation about any rule breaking is likely to still linger.

“Employers would probably be somewhat wary of doing that,” he says. “Just because they’re not wanting to facilitate something that remains illegal at the federal level.”

Emma Burleigh
emma.burleigh@fortune.com

Around the Table

A round-up of the most important HR headlines.

Elon Musk says that some of the severance packages distributed to former Tesla employees are too low, and he plans to fix the mistake immediately. Bloomberg

Google fired 28 employees who participated in company sit-ins at New York and California offices, as dozens of staffers protest the company’s dealings with the Israeli government. New York Times

Samsung is imposing a six-day workweek for all its executives following poor business results across most of the company’s major units. Business Insider

Watercooler

Everything you need to know from Fortune.

Fun with robots. An HR expert says companies should combat workers’ fears over AI by encouraging them to use the tools in a “structured and playful way.” —Christiaan Hetzner

Organizing with Mickey. More than two-third of Disneyland character and parade workers filed to unionize with the Actor’s Equity Association, organizing for better pay and safety. —Chris Morris

New standard. Michelin is implementing a standard minimum wage for all its global employees after leaders were informed many workers were living on the brink. —Ryan Hogg

Get rich quick. A handful of big tech, finance, and consulting companies are paying their interns six-figure salaries. —Orianna Rosa Royle

This is the web version of CHRO Daily, a newsletter focusing on helping HR executives navigate the needs of the workplace. Sign up to get it delivered free to your inbox.

About the Author
Emma Burleigh
By Emma BurleighReporter, Success

Emma Burleigh is a reporter at Fortune, covering success, careers, entrepreneurship, and personal finance. Before joining the Success desk, she co-authored Fortune’s CHRO Daily newsletter, extensively covering the workplace and the future of jobs. Emma has also written for publications including the Observer and The China Project, publishing long-form stories on culture, entertainment, and geopolitics. She has a joint-master’s degree from New York University in Global Journalism and East Asian Studies.

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