NH Health Issue Questions for the 2016 Presidential Candidates

The New Hampshire Medical Society has requested that each of the presidential candidates provide responses to four specific questions below impacting the health and wellbeing of Granite Staters. Requests were made to each candidate by mail and e-mail. The responses are being shared with New Hampshire physicians and their medical teams prior to the primary election on February 9, 2016 to help better inform them of the candidates’ policy positions on these issues.

Responses are being posted on a rolling basis as they are received and the posts are in alphabetical order based on the candidates’ last names.

1) The people of New Hampshire are being harmed by addiction to heroin and other opioid drugs, alcohol and tobacco. We know that treatment for addiction works. What would you do as president to ensure that people struggling with addiction get the treatment they need for recovery?

Jeb Bush – "I recently released a drug control strategy, specially addressing opioid and illicit drug abuse. I believe some government leaders label these epidemics just a criminal justice issue, and some try to make them just a health care issue. Both approaches oversimplify these complex challenges. The demand for abused and illicit drugs must be addressed in tandem with arresting the supply of these drugs. I believe we need a drug control strategy that prevents drug abuse and addiction before it begins; strengthens criminal justice; secures the border to stop the flow of illicit drugs; and improves drug abuse treatment and recovery programs.

My entire strategy can be viewed at www.jeb2016.com. The  plan specifically addresses treatment needed for recovery by increasing accountability for existing federal prevention, treatment and recovery resources. The Substance Abuse and Mental Health Services Administration (SAMHSA), whose mission is to advance the behavioral health of the nation, currently invests over 60 percent of its budget on prevention and treatment. However, GAO has evaluated SAMHSA' s stewardship of federal dollars, particularly on mental health programs, and found poor oversight of current programs and limited coordination of efforts across the federal government. As President, I will conduct a rigorous evaluation and overhaul of existing programs to ensure funding supports evidence-based programs for states and to consistently measure and monitor results. Funding should support proven models, including community­ based programs with peer counseling and recovery communities that provide ongoing support to individuals and families. In addition, I will review and streamline current programs across the federal government to reduce duplication of efforts and maximize impact."

Benjamin S. Carson, MD – no response received to date

Chris Christie – "While the challenge of drug addiction has taken on new national prominence in recent months, Chris Christie has been advocating for helping the drug addicted reclaim their lives for nearly two decades. As Governor of New Jersey, Chris Christie has backed up his rhetoric about changing the conversation on drug addiction by enacting concrete reforms to help non-violent drug offenders reclaim their lives.

  • Governor Christie championed the use of drug courts in New Jersey, which give first time, non-violent offenders, the opportunity to get the treatment they need rather than serving jail time.

  • Christie implemented a statewide program to help reduce the number of heroin-related deaths by training and equipping police officers and first responders to administer the antidote Narcan to overdose victims.

  • Governor Chris Christie signed the bipartisan Overdose Protection Act into law, which provides legal protection to people who are in violation of the law while they are attempting to help a drug overdose victim.

  • In his 2016 State of the State Address, Governor Christie announced the closing of a NJ prison to create the state's first ever fully dedicated substance abuse disorder treatment facility for prison inmates.  He also announced a landmark financial commitment of $100 million to bolster drug treatment."

Hillary Clinton – "On my first campaign trip New Hampshire last spring a retired doctor raised the rising tide of heroin addiction in the state and it’s come up again and again. Substance use disorders touch Americans everywhere. This problem certainly did not appear overnight, but it is worsening, and the costs of not doing more are huge: reduced productivity, overloaded health care and criminal justice systems, and hundreds of thousands of human lives lost. That’s why I’ve made confronting the substance use and addiction epidemic central to my campaign. The plan I’ve laid out incorporates many of the same measures proposed by your own state’s leaders, including Governor Hassan and Senator Shaheen.

First, we need to boost federal-state partnerships that empower state and local leaders to tailor programs to their communities, encouraging states to implement preventive programming for adolescents about drug use and addiction, because we know early intervention is crucial to fighting this epidemic.  I will ensure all first responders have access to naloxone, which can prevent opioid overdoses from becoming fatal, and require licensed prescribers to meet requirements for a minimum amount of training and consult a prescription drug-monitoring program before writing a prescription for controlled medications. My plan prioritizes rehabilitation and treatment over prison, calling for more collaboration and coordination between the public health and criminal justice systems to ensure continuity of care for those who suffer from substance use disorders.

And my plan takes immediate federal actions, including increasing the Substance Abuse Prevention and Treatment Block Grant; ensuring federal insurance parity laws are enforced; re-evaluating Medicare and Medicaid payment practices to ensure we’re making treatment accessible; removing obstacles to reimbursement and helping integrate care for addiction into standard practice; and directing the attorney general to issue guidance on prioritizing treatment over imprisonment for nonviolent, low-level drug offenders."

Ted Cruz – no response received to date

Carly Fiorina – no response received to date

Mike Huckabee – no response received to date

John R. Kasich – "The battle against drug addiction has been a top priority for Gov. Kasich.  His approach is to create a coordinated campaign that tackles the problem from all angles.  He will embrace this approach at a national level as president. You can find more details about this work here. The highlights include:

  • Targeting drug trafficking – closing pill mills and seizing record amounts of illegal drugs
  • Addressing prescription drug abuse with prescribing guidelines for physicians and better utilization of our Rx monitoring system
  • Increasing access to addiction treatment
  • Targeting prevention – rolling out the new Start Talking campaign in schools
  • Improving access to naloxone, a life-saving overdose antidote"

Martin J. O’Malley – "I know the challenges New Hampshire is facing first hand, because I lived them as Mayor of Baltimore and Governor of Maryland. In fact, I’ve spent the last 15 years bringing all resources to bear to stop the epidemic of drug addiction and overdose. In Baltimore, I expanded access to drug treatment to thousands of people while more than doubling funding for the city’s treatment system. Our innovative efforts drove a 60 percent reduction in overdose deaths from heroin over 10 years—and our program is still cited as a successful national model. And as Governor, I made addressing addiction one of my Administration’s top goals. We brought state agencies and local governments together to collaborate on reducing overdose deaths, increased addiction treatment services by 45 percent, helped doctors identify and treat substance use disorder, and empowered pharmacies and first responders to stock and safely administer overdose-reversing drugs.  

As president, I will hold this same commitment to saving lives and addressing addiction, using many of the same tools that were successful in my state. Over the next decade, I will invest $12 billion in federal and local partnerships to tackle addiction prevention, treatment, and recovery. First, I will work with doctors to stop over-prescription of pain medications, so we can stop addiction before it starts. Second, I will expand access to treatment—increasing funding for effective therapies by providing targeted resources to states that commit to expanding access to care. Third, I will invest in the community resources for recovery. You can read about each of these proposals at https://martinomalley.com/policy/addiction-treatment-and-prevention/."

Rand Paul, MD – no response received to date

Marco Rubio – no response received to date

Bernie Sanders – "Addiction to opioids - prescription pain medications like OxyContin and illegal drugs like heroin - is a serious problem we must address in this country.  It is, simply put, a public health emergency.

I have seen the devastation of opioid addiction in New Hampshire, in my home state of Vermont and around this country.  Between 2000 and 2014, we saw an increase in opioid abuse in Vermont of 800 percent.  In New Hampshire, there were 300 drug-related deaths last year.  Tragically, opiate use too often leads to death or incarceration.  This has to change.

I've talked to students, I've taked to veterans, I've talked to members of law enforcement and I've talked to professionals who help people living with addiction.  And two things are abundantly clear - we need to focus on prevention and we need to focus on treatment.

Focusing on prevention means asking: Why are people turning to opioids, turning to heroin, in the first place? What should we be doing differently to keep that from happening? One big thing we can do, we must do, is to address income inequality in this country.  We have to make sure hardworking people can find a job, that the job they find pays a livable wage, and a fair wage.  Today, unemployment and underemployment remains far too high, particularly amoung our country's young people.

A focus on both prevention and treatment means that health care professionals across this country not only need to take steps to reduce unnecessary prescribing of opiates and work with public health officials to address this crisis, but also to provide access to treatment for those individuals who seek help for their addictions.  If someone is addicted to opiates and they go to get help and they are told there is a six month or 1 year waiting list for treatment, that is not an acceptable solution. 

We also need to give people options for treatment for both mental health diagnoses and to manage chronic pain.  As the former Chairman of the Veterans' Affairs Committee in the Senate, I have met with veterans all over this country who need mental health and substance use disorder services.  I have introduced legislation in the Senate to improve access to complementary and alternative therapies for veterans, so they aren't left with the false option of either being in excruciating pain or at risk for opioid addiction.  Therapies like yoga and guided meditation can help manage pain and reduce stress with zero risk of addiction.

I support expanding programs like the one in Manchester, New Hampshire that offers peer-to-peer counseling because I have seen how effective it can be for someone in treatment to get help from someone who has walked in their shoes and come out the other side of addiction.

Progress is possible.  In my home state of Vermont, we have seen the devastation of opoid abuse but we've also seen success.  The people of Vermont have benefited from $3.8 million in funding from the federal government to deliver substance abuse prevention and addiction treatment for at-risk youth.  And, between 2010 and 2014, we have quadrupled the number of people getting help through programs that use medication to assist in treatment.  And for many, many people, those treatments are helping.

But the medications that help with treatment are expensive, and many cities and states are experiencing sticker shock.  I've contacted mayors, county officials, governors and attorney's general to encourage them to stand up to these drug companies to combat these high prices.  We are facing a public health emergency and the drug companies are profiting.  But we can stand up to them.  With a supported and well-trained health care workforce, expanded access to prevention and treatment services, and a united message to pharmaceutical company CEOs, we can address our opiate epidemic and ensure access to life-saving tyreatments in New Hampshire and around the country." 

Donald J. Trump – no response received to date

2) To extend affordable health care and improve public health, how would you improve, build upon, or offer as an alternative to the current federal systems?

Jeb Bush – "ObamaCare enabled Washington control of more than one-sixth of the American economy, and it confiscated citizens ' ability to select a health plan, a hospital and even  a doctor. It  epitomizes why Americans are so fed up with Washington.  Government inserts itself into our daily lives, fails to keep its promises, fails to recognize unintended consequences, spends trillions of dollars the country does not have, disrupts the lives of millions of Americans and leaves many worse off. Americans are frustrated - and they have a right to be.

I worked with physicians in Florida to achieve transformational reforms -such as medical liability reform, transparency, and Medicaid reforms that empowered patients. And as President of the United  States, I would make fixing our broken health care system one of my top priorities. I believe health care reform should actually lower costs. Physicians should be able to lead on solutions that help patients, lower costs and improve access to care - just like American ingenuity does in other sectors of the economy.
ObamaCare must be repealed and replaced, and I'm the only Republican candidate in the race with a plan to do that and position American health care for the possibilities of the 21st century: https://jeb2016.com/backgrounder-health-care-plan/?lang=en. My plan will get Washington out of the way and empower patients with more choices, security and control over their health care decisions. These reforms will not only lower the costs of care, they will substantially lower federal spending. They will enable a modem system that is convenient, affordable, accessible and results-oriented."

Benjamin S. Carson, MD – no response received to date

Chris Christie –  "Governor Christie believes that Obamacare has been a total failure. As president, he would repeal Obamacare and send it all back to every state. Every state in this country is different. Every state has different challenges. 

  • Chris Christie: “The Constitution says that if the power is not listed in there for federal government, it goes back to the states. I have read the Constitution, I don't see health care anywhere in there. It needs to go back to the states and the states should have one year to come up with their plan, the governors and the legislatures. And then you can have the most effect on it.” (Fox News The Kelly File – Luntz Focus Group, 12/18/15)"

Hillary Clinton – "The response to Medicaid expansion in New Hampshire shows how important the Affordable Care Act has been for the millions of Americans who need access to quality, affordable health care – including over 40,000 New Hampshire residents who were able to enroll under Medicaid expansion. I understand that the budget compromise reached in September by Governor Hassan and legislators does not include re-authorization, and that the Governor is taking Republican leadership at their word that they will take up re-authorization as soon as possible.  I think Governor Hassan is right to push for making the expansion permanent.

As I have said many times in my campaign, I am committed to defending and building on the Affordable Care Act to make coverage more affordable and accessible.  We do that, first, by getting spending under control, so my plan will make families’ insurance more affordable through increased relief for out-of-pocket spending and caps on prescription drug costs, while at the same time working to slow the rise in health care costs. We have a real chance to build upon the achievement of the ACA, get our spending under control, and continue to increase access for millions of Americans. As president I will continue this fight."

Ted Cruz – no response received to date

Carly Fiorina – no response received to date

Mike Huckabee – no response received to date

John R. Kasich – Access to affordable health care, is a top priority for Gov. Kasich. You can learn more about a few of his priorities here 

Martin J. O’Malley – "The key to changing healthcare is to align incentives for better health. Proposals that focus largely on who is paying the bill – not on what we’re paying for – or just make incremental changes don’t go far enough.

My health care plan builds on the Affordable Care Act, based on our experience in Maryland. As Governor, I put all our hospitals on global budgets, across all patients, giving them a financial interest in reducing preventable admissions and keeping their communities healthy. They succeeded right away, dramatically rethinking how they provided care, and saving Medicare more than $100 million in the first year alone.

As president, I will encourage all states to adopt similarly bold “all payer” reforms that promote prevention and health. This something they can do right away to bring down costs and improve the quality of care – without waiting on Congress or re-litigating old battles. I will also put politics aside to expand Medicaid. States should have the flexibility to experiment with different ways of expanding coverage, as New Hampshire has—provided they meet the basic parameters about beneficiary rights and covered services, including access to primary care and preventative services. And I will focus on helping the increasing number of Americans who do have insurance, but are finding that more and more of their health care expenses are coming out of pocket. That means working with and requiring insurance companies to cover critical services that keep people healthy—including certain drugs—with no deductibles or out-of-pocket costs. It simply doesn’t make sense to wait until after people get sick to care for them. 

All of these policies, as well as a number of other specific reforms and investments, are detailed in my comprehensive health care plan at https://martinomalley.com/policy/health-care/."

Rand Paul, MD – no response received to date

Marco Rubio – no response received to date

Bernie Sanders – "The Affordable Care Act was a critically important step towards the goal of universal health care. Thanks to the ACA, more than 17 million Americans have gained health insurance. Millions of low-income Americans have coverage through expanded eligibility for Medicaid that now exists in 31 states. Young adults can stay on their parents' health plans until they're 26. All Americans can benefit from increased protections against lifetime coverage limits and exclusion from coverage because of pre-existing conditions. I was on the U.S. Senate committee that helped write the ACA.

But as we move forward, we must build upon the success of the ACA to achieve the goal of universal health care. Twenty-nine million Americans today still do not have health insurance and millions more are underinsured and cannot afford the high copayments and deductibles charged by private health insurance companies that put profits before people. 

The U.S. spends more on health care per person per year (nearly $10,000), and as a percentage of gross domestic product, than any other advanced nation in the world. Other industrialized nations are making the morally principled and financially responsible decision to provide universal health care to all of their people - and they do so while saving money by keeping people healthier. Those who say this goal is unachievable are selling the American people short.

My plan would create a federally administered single-payer health care program. Universal single-payer health care means comprehensive coverage for all Americans. My plan will cover the entire continuum of health care, from inpatient to outpatient care; preventive to emergency care; primary care to specialty care, including long-term and palliative care; vision, hearing and oral health care; mental health and substance abuse services; as well as prescription medications and medical equiment. Patients will be able to choose a health care provider without worrying about wether that provider is in-network, and health care providers will be able to offer the best treatment for their patients regardless of that patients' insurance status or ability to pay.

As a patient, all you need to do is go to the doctor and show your insurance card. My plan means no more copays, no more deductibles and no more fighting with insurance companies when they fail to pay for charges.

Creating a single, public insurance system will go a long way towards getting health care spending under control. The United States has thousands of different health insurance plans, all of which set different reimbursement rates across different networks for providers and procedures resulting in high administrative costs. In fact, a great deal of research showing the geographic differences in health spending has been conducted in New Hampshire at the Dartmouth Instititute for Health Policy and Clinical Practice. Two patients with the same condition may get very different care - pay very different amounts for the same care - depending on where they live, the health insurance they have and what their insurance covers. Health care providers and patients must navigate this complex and bewildering system wasting precious time and resources.

By moving to an integrated system, the government will finally have the ability to stand up to drug companies and negotiate fair prices for the American people collectively. It will also ensure the federal government can track access to various providers and make smart investments to avoid provider shortages and ensure communities can access the providers they need. We need to ensure a strong health care workforce in all communities now and in the future. We need to build on the strength of the 50 years of success of the Medicare program.

We need a health care system that significantly reduces overhead, administrative costs and complexity. We need a system where all people can get the care they need to maintan and improve their health when they need it regardless of income, age or socioeconomic status. We need a system that works not just for millionaires and billionaires, but for all of us.

My plan will cost over $6 trillion less than the current health care system over the next ten years and will pay for new public spending with:

  • employer-paid premiums (6.2% of salary instead of the high monthly contributions paid now);
  • premiums paid by households (2.2% of taxable income instead of the monthly premiums taken from your paycheck now);
  • income tax increases on the richest 2.1% (higher marginal tax rates and other reforms mainly affecting incomes over $500,000); and
  • estate tax reforms affecting the wealthiest 0.3% of families.

Businesses would save over $9,400 a year in health care costs for the average employee. The typical middle class family would save over $5,000 under this plan. Last year, the average working family paid $4,955 in premiums and $1,318 in deductibles to private health insurance companies. Under this plan, a family of four earning $50,000 would pay just $466 per year to the single-payer program. That amounts to a savings of over $5,800 for that average family each year."

Donald J. Trump – no response received to date

3) Many physicians are concerned about the rapidly escalating cost of prescription drugs. What would you do as President to help address this predicament?

Jeb Bush – "We need to address the underlying problems causing prices to skyrocket. It should not cost $1.2 billion to $2.6 billion nor take 12 to 15 years to advance a medicine from discovery to patients, but that is the case under the Food and Drug Administration's (FDA) current regulatory mess. I have proposed a plan to modernize the FDA to reduce approval times and the cost to develop prescription drugs. In addition, consumers deserve better transparency about the value of their care, including their prescription drugs. I have proposed transparency standards so that consumers have access to key information on price, outcomes and performance. The solution to skyrocketed drug costs must put patients at the center -they deserve more innovative treatments, better value for health care dollars, and more transparency on what will work for them."

Benjamin S. Carson, MD – no response received to date

Chris Christie – "Kathie Obradovich: "Do you agree with Hillary Clinton Medicare should be able to negotiate prescription drug prices under - right now you can't, the federal government can't negotiate prescription drug prices under Medicare."
Chris Christie: "I think what Mrs. Clinton is really going for is for price controls, which I don't agree with. We want our pharmaceutical companies to continue to invest in research and development, which is extraordinarily expensive - tens of billions of dollars. They need to be able to make that money back to invest. Because if they don't, we're not going to get the next cures, the next treatments that we need."
Kathie Obradovich: "So, she's going to far by saying marketing money should be moved into research and development?"
Chris Christie: "Hillary Clinton not only wants to be president of the United States, but she wants to be CEO of every pharmaceutical company. She's an extraordinary woman. But, I don't think she can do all that at one. She should let those CEOs and the shareholders, by the way, which help make those decisions - make those decisions, not have the government. This is the difference between me and Hillary Clinton. She wants the government to make every decision - that's a perfect example of it. I believe the American people should make those decisions and government should stay out of the way." (CBS Des Moines Interview, 10/25/15)" 

Hillary Clinton – "We must promote competition and leverage our nation’s bargaining power to lower drug costs on behalf of Americans.  That’s why I have laid out a plan to hold the pharmaceutical industry accountable and rein in drug costs for American families. My plan demands a stop to excessive profiteering and marketing by denying tax breaks for direct-to-consumer advertising and demanding that drug companies invest in R&D in exchange for taxpayer support – rather than marketing or excessive profits. I will encourage competition to get more generics on the market and create a Federal backstop for when there are excessively high-priced drugs that face no competition. And for Americans struggling with prescription drug cost burdens, I will cap what insurers can charge consumers in out-of-pocket costs, putting money back in the family wallet.

This isn’t a new fight for me. I’ve fought the special interests to get affordable health care throughout my career. As a senator, I called for allowing Medicare to negotiate with drug companies to reduce prices and rein in costs. And I will continue this fight as president."

Ted Cruz – no response received to date

Carly Fiorina – no response received to date

Mike Huckabee – no response received to date

John R. Kasich – no response received to date

Martin J. O’Malley – "I have heard far too many of these stories across the country, from people who can’t afford the medicines they need. Helping these families is one of my top health care priorities as president.  

I’ve put forward a comprehensive plan for reining in prescription drug costs. It starts with using the purchasing power of the federal government to get the best possible price for each drug, by allowing Medicare to negotiate drug prices, together with Medicaid and the VA. I will also fight for legislation to ban price gouging for prescription drugs. Just like we stop price gouging of gasoline during a fuel shortage, nobody should be able to jack up the price of a drug arbitrarily overnight. If government exists for anything, it is to prevent the exploitation of the sick and this kind of abuse. Finally, I will fight against corporate tax inversions and health care monopolies that squash U.S. competition and investment, and can lead to dramatic price increases for prescription drugs and other care."

Rand Paul, MD – no response received to date

Marco Rubio – no response received to date

Bernie Sanders – "Access to health care is a human right, and that includes access to safe and affordable prescription drugs. It is time to enact prescription drug policies that work for everyone, not just the CEOs of the pharmaceutical industry, and it is time we end the national disgrace of the United States being the only major country that does not guarantee health care to all people as a right.

I have proposed a Medicare-for-All health care system that expands the list of minimum health benefits currently guaranteed by the Affordable Care Act and would fully cover expenses for prescription drugs, eyeglasses, and hearing aids. My plan would allow states to innovate while holding everyone to a high standard.

In addition, Americans pay, by far, the highest prices for prescription drugs in the entire world. When we talk about health care, we are talking about the need of the American people to be able to afford the medicine their health care providers prescribe. A life-saving drug does no good if the people who need it cannot afford that drug.

I recently introduced the Prescription Drug Affordability Act of 2015 that, among other things, instructs the Secretary of Health and Human Services to negotiate drug prices with pharmaceutical companies to bring down prescription drug prices for Medicare beneficiaries. We must use our buying power to get better deals for the American people, just like other countries throughout the world do. Not only would negotiation substantially reduce prices seniors and people with disabilities pay for drugs, it could save Medicare up to $541 billion dollars over the next decade, according to a study from the Center for Economic and Policy Research.

I also believe that we must allow individuals, pharmacists and wholesalers to import prescription drugs from licensed Canadian pharmacies. In 1999, I became the first Member of Congress to take a busload of Americans across the border into Canada to purchase prescription drugs. Americans should not have to pay higher prices for the exact same drugs than our Canadian neighbors simply because Congress is bought and paid for by the powerful pharmaceutical industry.

My legislation would also close the Medicare Part D donut hole for brand and generic drugs by 2017 (three years earlier than under current law), hold the pharmaceutical industry accountable when they defraud the American people by enacting stronger penalties for fraud, and require drug companies to publicly report information that affects drug pricing. Companies routinely distort the true cost of drug research and development to justify skyrocketing prescription drug prices. Under my plan, drug makers would be required to report certain price expenditures on research and development and clinical trials, as well as the portion of their drug development expenses offset by tax credits or paid for by federal grants.

Most Americans - Republicans, Democrats, and independents - want Congress to do something about drug prices, and in fact there are steps the Administration can take on this issue to lower drug prices that do not require Congressional action. Tens of thousands of Americans now spend more than $100,000 a year on prescription medications. Drug costs are out of control because that's the way pharmaceutical companies want it. As President, I will work hard to take on the pharmaceutical industry and address skyrocketing drug prices."

Donald J. Trump – no response received to date

4) Do you support or oppose the legalization of marijuana, and why?

Jeb Bush – "I do not support legalizing marijuana. While I believe states should decide their own policies, I believe legalizing marijuana will lead us down an incredibly slippery slope. Specifically, I am concerned about the subsequent public health costs associated with legalizing marijuana. Along with temporarily clouding one's judgment, the use of marijuana has been shown to have long-term, negative impacts on cognitive development and cognitive ability. The fact that marijuana use can permanently hinder adolescent brain development is particularly troubling and is one of many worthy reasons to restrict the availability of  marijuana.
I also believe we should strive to give people a  second chance. As Governor of Florida, I took the lead in developing drug courts, which addressed certain drug crimes through supervision, drug testing, and treatment, as an alternative to long prison sentences for non-violent drug offenders."

Benjamin S. Carson, MD – no response received to date

Chris Christie – "I’m opposed to legalizing marijuana. Absolutely opposed to legalizing marijuana and here’s why. We know from every study we’ve read out there that it has negative long-term effective on the brain’s ability to function, no question about it and any medical study you look at has shown that. Secondly, we know that it’s a gateway drug to other drugs – not for every person – not every person who has taken marijuana goes on to take cocaine or heroin but a lot of them do. And I don’t want to send a message, not only to our young people but to anybody in the country that it’s okay; it’s not." (NH Town Hall, 7/2/15) 

Hillary Clinton – "I support the use of medical marijuana, and I support rescheduling marijuana from a Schedule I to a Schedule II substance to advance greater research into its health benefits.  I also support allowing states to be the laboratories of democracy on this, as long as they adhere to certain federal priorities such as not selling to minors, preventing intoxicated driving, and keeping organized crime out of the industry." 

Ted Cruz – no response received to date

Carly Fiorina – no response received to date

Mike Huckabee – no response received to date

John R. Kasich – no response received to date

Martin J. O’Malley – "As Governor, I decriminalized the possession of marijuana in Maryland, because we wanted to make our justice system fairer and allow our law enforcement officers to focus on violent crime. That’s why I was the first candidate to make marijuana legalization a key issue in my campaign – voicing support for states like Colorado and Washington who are legalizing marijuana, and visiting those states to meet with business and policy leaders to learn more about how it's working for them.

As president, I will continue to support states as laboratories of democracy in experimenting with new marijuana policies. In addition, I will reclassify marijuana, including by executive order if Congress fails to act. I will work to eliminate mandatory minimum sentences for low-level drug offenses, and provide pathways for people to seal or expunge their criminal records – including (and especially for) young people. We took similar steps in Maryland, and they worked to reduce incarceration and help people find good jobs. And I will support legislation like the Marijuana Businesses Access to Banking Act, which would allow businesses operating legally under state law to access banking services; as well as the Compassionate Access, Research Expansion, and Respect States Act to let states to set their own medical marijuana policies, allow youth with epilepsy and veterans’ doctors to use marijuana as a medical treatment, and expand opportunities for medical research."

Rand Paul, MD – no response received to date

Marco Rubio – no response received to date

Bernie Sanders – "According to FBI crime data, in 2014 there were over 600,000 arrests for marijuana possession in the United States - more than one every minute. Meanwhile, marijuana use is now legal in four states and the District of Columbia.

Though most arrests likely lead to a fine and not jail time, an arrest record still follows a person around for a lifetime, making it harder for a person to find a job or housing. It is an obscenity that we stigmatize so many young Americans with a criminal record for smoking marijuana, but not one major Wall Street executive has been prosecuted for causing the near collapse of our entire economy.

In my view, it is absurd that the federal government classifies marijuana as a Schedule I drug, deeming it as dangerous, with no medical value and potentially as addictive as heroin, another Schedule I drug.  In fact, under the Controlled Substances Act, marijuana is considered more dangerous than oxycodone.

Thanks to these federal regulations, states that want to move ahead on marijuana legalization are in a precarious position. Shop owners cannot legally do business with banks and are still at risk of arrest from federal agents. Those patients who use marijuana for medical purposes could find that option taken away from them under a Republican president. This must change. It is time to take marijuana off of the federal list of controlled substances and give states the ability to legalize, regulate, and tax marijuana without interference from the federal government.

I introduced a bill that would do just that. My bill would simply remove marijuana from the jurisdiction fo the CSA. It would not legalize marijuana, but would place marijuana in the same legal category as alcohol and tobacco. States would be free to legalize or continue to ban it. But I would hope that states that keep simple marijuana possession illegal recognize that enforcing that law should be one of its lowest priorities and devote police resources to other matters."

Donald J. Trump – no response received to date