Why the Compassionate Care Act Keeps Dying

Last verified: April 2026

The Bill That Won’t Die and Won’t Pass

The vehicle has consistently been the NC Compassionate Care Act, championed by Sen. William P. “Bill” Rabon (R-Brunswick, District 8) — the Senate Rules Committee chair, a veterinarian, and a stage-3 colon cancer survivor. Rabon disclosed in House Health Committee testimony on May 30, 2023 that he had used illegally obtained cannabis during chemotherapy on his oncologist’s advice. His quote — “I know that tens of thousands of people in the state would benefit just as I did” — has become the bill’s signature line. See Sen. Rabon’s story for the human anchor.

Five Sessions, Three Senate Wins, Zero House Votes

The Chokepoint: “Majority of the Majority”

The chokepoint isn’t any single chair or committee — it’s the House Republican caucus, operating under former Speaker Tim Moore’s informal “majority of the majority” rule (in force 2015–2024). Under that rule, a bill cannot reach the House floor without majority support from the GOP caucus alone — bipartisan support across the chamber doesn’t matter. Internal GOP caucus polls in 2022, 2023, and 2024 consistently fell short of a Republican majority for the Compassionate Care Act, even as overall House support clearly existed.

Speaker Moore publicly said he personally supported medical cannabis but adhered to the rule. House Majority Leader John Bell (R-Wayne) told reporters in 2023 he was “very sure you won’t see that bill move.” Sens. Jim Burgin (R), Norm Sanderson (R-Pamlico), and Ted Davis (R) led the named opposition; outside groups included the NC Family Policy Council and NC Citizens Against Legalizing Marijuana.

Under the "majority of the majority" rule, a bill cannot reach the House floor without majority support from the GOP caucus alone, even when bipartisan majorities exist in the full chamber.

NC House Speaker Tim Moore, 2015–2024 practice

What Changed in 2025

Three things shifted in 2025:

1. Speaker Moore departed for Congress (NC-14) in January 2025. The new Speaker is Destin Hall (R-Caldwell), formerly Rules chair. Hall has voiced personal skepticism but told the News & Observer in March 2025 that “House Republicans could be more open to what the Senate sends over to them” this session.
2. The Republican supermajority margin dropped by one seat in the November 2024 elections, mathematically lowering the caucus threshold by one vote.
3. Sen. Rabon did not refile the Compassionate Care Act in the 2025 session. The vehicle has shifted to House Democrats (HB 1011, sponsored by Reps. Aisha Dew, Pricey Harrison, and Zack Hawkins) without Republican co-sponsors — a meaningful break in Rabon’s championship and a sign the Senate strategy has temporarily collapsed.

Gov. Stein’s NC Advisory Council

Gov. Josh Stein (D, sworn in January 1, 2025; former AG and TREC co-chair) issued Executive Order No. 16 on June 3, 2025, creating the NC Advisory Council on Cannabis. Co-chaired by State Health Director Dr. Lawrence H. Greenblatt and DA Matt Scott (Robeson County), the council includes Sens. Rabon and Kandie Smith (D), Reps. John Bell (R) and Zack Hawkins (D), and Qualla Enterprises GM Forrest Parker.

The council’s April 2, 2026 interim report found NC has the second-largest unregulated cannabis market in the U.S. (~$3.2 billion in 2023) and recommended full adult-use legalization with regulated retail to adults 21+. Gov. Stein endorsed the recommendation. Speaker Hall and Senate leader Phil Berger had not publicly responded as of WRAL’s coverage. The final report is due December 2026 — a forced inflection point for the legislature.

The Public Mandate That Doesn’t Translate

Public opinion has been steadily, lopsidedly pro-medical for years:

• Meredith College Poll (February 2025): 71% support for medical cannabis, with majorities across all party and demographic subgroups except those 80+.
• Elon University polling (2022): 82% support for medical cannabis; 62% support for adult-use.

The polls don’t move the legislature because polling is not the constraint — the “majority of the majority” rule and individual GOP caucus dynamics are. See the 2026 outlook for whether 2026/27 will finally break the stalemate.

Explore the Compassionate Care Act

Official Sources

• North Carolina General Assembly
• Sen. Bill Rabon (NCGA)
• Office of Governor Josh Stein
• Meredith College Poll