Five medical-marijuana dispensaries will soon open their doors for business as Iowa’s recently expanded medical-marijuana program gets underway.

On Saturday, five state-approved dispensaries will begin selling the first medical- marijuana products in Iowa, including tinctures, capsules, and creams, to legally registered patients. To qualify for the program, a patient must be able to prove permanent Iowa residency and provide a physician’s certification of a qualifying medical condition.

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But some Iowa legislators advocate expanding the medical-marijuana program in the upcoming legislative session, contending that the current program is too restrictive and limits both businesses and the patients seeking to use the products.

“I will introduce legislation again this year to create a better program that actually helps,” said Sen. Joe Bolkcom, D-Iowa City. “People are going to be very disappointed on Dec. 1, when they find out that the medicine available to them is ineffective, 1, and 2, for people that have chronic conditions that are not covered under the bill.”

Bolkcom, a leading proponent of medical marijuana, is referring to the Medical Cannabidiol Act, which the Legislature passed in 2017 to legalize the limited use of medical marijuana. The act made Iowa one of 46 states in the nation to have some form of medical marijuana in place.

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The current law allows up to two in-state businesses to grow marijuana and produce products with up to 3 percent of THC — the chemical that makes recreational marijuana users high — to be distributed at five state-approved dispensaries. The law also outlines who qualifies for Iowa’s medical marijuana.

To qualify, a patient must be able to prove permanent Iowa residency and provide physician certification of one of nine qualifying medical conditions, including cancer, multiple sclerosis, HIV/AIDs, Parkinson’s disease, ALS, among others.

Bolkcom said he would like to see the removal of the 3 percent THC cap and a longer list of approved conditions for which patients can purchase medical marijuana.

State Senate President Jack Whitver, R-Ankeny, said there is interest in the Senate to grow the program.

“I think our caucus has shown in the past that we’re willing to expand that to where it’s a system that actually works for the companies that have invested in that industry,” he said. “Right now, the system is set up to where it’s hard for those companies to be profitable and for that industry to be sustainable.”

In the last legislative session, the Iowa Senate passed a broader bill on a 45-5 vote that would have allowed for patients with a wider range of conditions to have access to medical-marijuana products and reclassified marijuana under state law. But the bill was never taken up in the House.

House Speaker Linda Upmeyer, R-Clear Lake, said in an email to The Daily Iowan that she doesn’t want to change the law because the Medical Cannabidiol Board, composed mainly of physicians, has not made recommendations on changing the current program.

In a meeting on Nov. 2, the board voted not to recommend any change to the THC cap.

“We established the state system with a board of medical professionals and law enforcement who provide us with recommendations to expand or improve our program,” Upmeyer said. “They are not suggesting any dramatic changes at this time. They are the experts and we will make changes based on their study and recommendations.”

Bolkcom said that Upmeyer has been a “roadblock” to putting in place a progressive medical-cannabis program and hopes that new members in the Legislature will “fix this law.”

“It’s time to fix this program and do it early in the 2019 session,” he said. “We’ve got companies that have made an enormous investment in Iowa trying to help suffering Iowans, and the economics of the current program are going to make it about impossible for them to stay in business because they’re not going to have enough patients to make their business models work.”

One of these companies is MedPharm Iowa, an approved producer of medical marijuana and owner of two of the five approved dispensaries. Like Bolkcom, it supports raising the THC limit and expanding the number of approved conditions.

A current concern if the restrictions stay in place is whether Iowa has a big enough market and clientele base to sustain such businesses as MedPharm Iowa. Currently, 1,466 patients and caregivers have been issued registration cards, which allow them to purchase medical marijuana, and 363 applications have been approved but the cards have not yet been issued, according to the Iowa Department of Public Health.

“We’re more than $10 million invested at this point right now, and that’s because we see a long-term future here in the state for this program,” said Lucas Nelson, the general manager of MedPharm Iowa. “I think if the program doesn’t expand and patients aren’t able to get the medicine that they need, eventually they’ll walk away and go down a different route, and without patients, we don’t have an industry here at all.”