New York’s medical marijuana program was approved after a lengthy public and private debate in the halls of the state Capitol. It took a lot of convincing of skeptics – as well as lobbying from drug reform advocates and state lawmakers – for the measure to pass last year.

 “Many people thought that the only reason why people wanted access to medical marijuana for medicinal reasons was they just wanted another way to get high. That was the biggest misconception,” said state Sen. Diane Savio, D-Staten Island. “So we had to spend a lot of time educating people about the medicinal value of marijuana and how it could have a beneficial effect on people with particular conditions.”

The measure was approved in 2014, but only after significant lobbying of one major skeptic: Governor Andrew Cuomo. In the end, Cuomo relented, but only after some major changes to the legislation supportive lawmakers like Savino had initially proposed.  

“In the beginning he was somewhat reluctant. I believe that he originally said he saw the benefit, but he believed the risks outweighed the benefits. With him, it was also an education process,” Savino said.

The legislation that was ultimately approved gives Cuomo broad authority over the state’s medical marijuana program, which is due to formally go on line for patients in January. Key to the governor’s approval was a mechanism that amounts to a kill switch: Cuomo can shut down the program at any time if he feels it is operating improperly.

 “I think that the discretion that the governor exercises is pretty extraordinary and unfortunately, he could have used that discretion to make a program that increased patient access and helped alleviate suffering in this state. But instead, he's chosen to use that discretion to narrow the program and really that's a disservice to patients,” said Julie Netherland, the deputy state director of the Drug Policy Alliance. 

The latitude granted the governor in the program isn’t the only aspect that doesn’t sit well with some advocates who lobbied for the measure. They point to only a handful of illnesses covered by the program as it’s due to launch.

“The medical marijuana program that's being implemented is incredibly narrow and restrictive -- I would say one of the narrowest in the country and unfortunately that's going to leave a lot of patients behind,” Netherland said.

New York’s medical marijuana legislation was approved more than a year ago. Five applicants have been selected to dispense medical cannabis around the state by January. And yet, the politics surrounding the medical marijuana debate continue to resonate. The application process itself was conducted with little fanfare and out of the public view. It’s unclear why, exactly, some applicants were selected over others. And some advocates remain bitterly disappointed an emergency program wasn’t set up to treat seriously ill children.

“In the 12, 13 months since the program was signed into law, four children have died affiliated with our campaign alone. Those are children who could have benefitted from medical marijuana. We there are people who need this medicine and need it right away,” Netherland said.

The Cuomo administration sought a federal waiver to import out-of-state medical-grade marijuana. They were turned down in a letter by the Department of Justice. Meanwhile, the incoming medical marijuana firms aren’t paying much attention to the political debate in New York.

 “We don’t believe that will have much of an impact on our businesses going forward and we’re really focusing on building our facility, so we’ll be online in time for January in New York,” said Kyle Kingsley, the CEO of Minnesota Health Solutions.

Likewise the application process, Kingsley says, didn’t involve much internal jockeying

“We took a different approach. We didn't do the political route. We really looked to putting together a merit-based application in New York and I really think the Department of Health really did a phenomenal job pulling in a range of experts to evaluate these applications,” Kingsley said.

Only the 43 companies seeking the five licenses in New York did commit to varying levels of lobbying, hiring government relations firms and public relations experts, spending thousands of dollars in the process.

“We know who the applicants were. We know who the winners were. So I don't know how much more transparency can be expected,” Savino said.

But what was the trick to getting a medical marijuana measure passed in the first place? The idea is gaining mainstream acceptance in medicine and in states around the country. New York isn’t certainly the first. In Minnesota, where the New York law broadly based its own medical marijuana program off, advocates were the patients themselves and encountered their own frustrations.

“Unfortunately in politics, people don't really look at evidence. They will look at politics,” said Patrick McClellan, a Minnesota resident. “The same way here in Minnesota, a lot of the conditions that were chosen because of evidence, they were chosen because of politics.”

Parents of potential medical marijuana patients were involved to – offering a personal story to skeptical elected officials that, ultimately, was hard to resist.

“When we started on this journey, we thought that if we don't fight for this, if we don't try to help Minnesota get this legalized, how can we do this as parents?” said Kelly Kaycie, also a Minnesota resident. “How can we not fight for something that would help your family member? Our thought was, if it helps a little, great. If it helps a lot, awesome.”