The 2026 South Carolina Compassionate Care Act: What’s Different This Session?

South Carolina is once again debating major changes to its cannabis laws through a proposal known as the South Carolina Compassionate Care Act. If passed, the bill would create a medical cannabis program in a state that still does not allow broad access to medical marijuana. During the 2026 legislative session, lawmakers are revising the bill in an effort to address past concerns and improve its chances of passing.

This article explains what the Compassionate Care Act would do, what has changed in the latest version, why the bill matters, what supporters and opponents argue, and what could happen next.

What Is the Compassionate Care Act?

The South Carolina Compassionate Care Act is a proposed law, known as Senate Bill 53. It would change state rules to allow medical cannabis. Medical cannabis means cannabis used with a doctor’s approval to treat certain serious health conditions.

If passed, the bill would set up a legal system that allows qualified patients to access cannabis products such as oils, edibles, tinctures, and topicals under medical supervision.

South Carolina’s Current Cannabis Landscape

Right now, South Carolina does not have a broad medical marijuana program. Patients cannot get medical cannabis cards like they can in most U.S. states. The only exception is a very limited allowance for high-CBD products for certain medical conditions under existing law.

Most cannabis products, including cannabis flower, are still illegal. Recreational use is not allowed, and possession or distribution can lead to criminal penalties. Because of this slow pace, South Carolina remains one of the few states that has not yet adopted a comprehensive medical cannabis program.

Main Goals of the 2026 Session Bill

Create a Regulated Medical Program

The Compassionate Care Act would create a full medical cannabis program with clear rules for production, testing, distribution, and patient access.

Key components are:

• Licensing system for cultivation centers, processors, pharmacies, testing labs, and transporters.

• State regulation and oversight by the Department of Public Health and the Board of Pharmacy.

• Rules for medical use, including registration cards for patients and caregivers.

This structure would replace the current limited access that South Carolinians have.

How Does the Bill Structure Products and Use?

The bill defines what kinds of cannabis products patients could legally obtain. These include:

• Edibles and oral products

• Topicals (like creams and lotions)

• Vapor-ready oils and extracts

The bill sets strict limits on how much cannabis a patient can get within two weeks. It also bans smoking and using the raw cannabis flower. These limits make the proposal more cautious compared to medical programs in many other states. The goal is to keep patients safe and reduce potential risks.

Licensing and Regulatory Rules

Under the 2026 session proposal:

• Cultivation centers would grow cannabis for medical use.

• Processing facilities would convert raw cannabis into approved products.

• Therapeutic cannabis pharmacies (dispensaries) would sell to patients and caregivers.

• Independent testing labs would check product safety.

The bill sets up a competitive application process. Companies that are local and have experience could get extra points. The bill focuses on strict licensing rules and detailed regulations. These are key parts of how it would work.

Medical Conditions and Patient Access

Patients would need a doctor’s approval to join the program. The conditions that qualify include serious illnesses like cancer, seizures, and chronic pain. Both patients and caregivers must have registry ID cards, which offer protection from some legal penalties if they follow the program rules. Doctors are required to have a real doctor-patient relationship, usually shown through multiple visits and documented medical records.

What’s New in the 2026 Session?

Refined Regulatory Framework

Compared to earlier versions, the current bill gives more detailed rules on licensing, packaging, testing, and safety. These updates reflect suggestions from both the industry and public health experts.

Sunset Clause

The bill includes a five-year sunset clause. If enacted, the program would automatically expire in five years unless lawmakers decide to renew it based on surveys and reports. This means lawmakers are building in a review period to assess the program’s impact. 

Focus on Patient Safety and Oversight

The bill now focuses more on lab testing, controlling diversion, and ensuring product safety than in some earlier versions. This change addresses concerns from critics about unregulated markets and potential misuse.

Political Challenges and Debate

Even after several attempts, the Compassionate Care Act has not been approved.

• In past sessions, versions of the bill passed the Senate but got stalled in the House.

• The House has at times ruled the bill out of order due to tax issues or procedural rules. 

• Some lawmakers have been skeptical or opposed due to law-and-order issues and public health concerns.

Public support for medical cannabis in South Carolina is fairly strong, even among different political parties. Still, the bill faces major challenges in the legislature.

How South Carolina Compares to Other States?

Most U.S. states already have medical cannabis laws, and South Carolina is still one of the few without one. In nearby states like North Carolina, efforts to reform cannabis are happening too, but through advisory councils and studies rather than full programs. This regional situation adds pressure on South Carolina, especially as residents travel to other states to access legal cannabis.

Why This Matters in 2026?

Patient Access and Health Care

The bill could give legal access to regulated medical treatments that patients with serious illnesses cannot get now. Without a program, some patients have to use cannabis illegally or travel to other states to receive care.

Economic and Regulatory Impact

If it becomes law, the Compassionate Care Act would start a new regulated industry by bringing jobs, tax revenue, and investment opportunities. The licensing system is designed to balance these economic opportunities with public safety.

Political Shift

A successful vote in 2026 would mark a major shift in the state’s approach to cannabis policy. South Carolina would join every other state that has adopted medical cannabis laws.

Conclusion

The 2026 South Carolina Compassionate Care Act marks an important point in the state’s long debate over medical cannabis. This version of the bill provides a clearer regulatory framework and includes a built-in review period, yet it still faces familiar political challenges. For patients, advocates, investors, and lawmakers, this session may be the closest South Carolina has come to legal medical cannabis. What happens in committee hearings, floor debates, and negotiations will decide whether the bill becomes law or ends up as another near miss in the state’s reform efforts.