Rep. Tom Price (R-Ga.), chairman of the House Budget Committee, at a news conference about the House Republicans' fiscal 2016 budget proposal. (Andrew Harrer/Bloomberg News)

President-elect Donald Trump on Tuesday named Rep. Tom Price (R-Ga.) as his pick for Health and Human Services secretary, a position that could offer the anti-marijuana legislator more control over medical access to the drug.

Although federal regulation of illicit drugs rests primarily with the Justice Department, the HHS secretary holds some powers that could restrict how available marijuana is in states that have legalized it for recreational or medicinal use. For instance, drug policy observers say that the agency could penalize doctors or sue sellers who work with medical marijuana in those states, since the substance remains illegal under federal law.

Price is one of the most consistently anti-marijuana members of Congress, voting against a number of marijuana proposals before the House in recent years.

“Price has a long voting record of opposing the [modest] marijuana policy reforms that have come to a vote in the House of Representatives,” said John Hudak of the Brookings Institution in an email. “Price is a physician and the medical community broadly has been conservative about the use of medical marijuana and nearly universally opposes it for recreational use.”

Price's record includes:

  • Going against a measure that would prevent the Justice Department from interfering with state recreational marijuana laws.
  • Voting six times against amendments preventing the Justice Department from interfering with state medical marijuana laws.
  • Voting three times against a measure that would allow Veterans Affairs doctors to recommend medical marijuana to veterans who might benefit from it.

But Price has supported a limited measure preventing the Justice Department from interfering with states that allow the medical use of cannabidiol, a non-psychoactive chemical component of marijuana that shows promise in treating some forms of epilepsy. He has also voted to ensure that federal funds aren't used to stymie research into industrial uses of hemp.

While not particularly vocal on the subject of marijuana law, Price's votes have earned him a “D” grade on marijuana policy from the National Organization for the Reform of Marijuana Laws and Drug Policy Action, two drug policy reform groups.

HHS chiefs have not been major presences in marijuana policy discussions during the Obama administration. But Ethan Nadelmann, executive director of the Drug Policy Alliance, still called the pick a “terrible development,” given other signs the Trump administration could take a harder line on to legal marijuana.

Trump has chosen anti-pot crusader Sen. Jeff Sessions (R-Ala.) for attorney general, and the president-elect also has been critical of legalization.

“We are having a throwback to some of the discredited drug war rhetoric and policies of the late '80s and '90s,” Nadelmann said.

Hudak said an HHS secretary wishing to make life difficult for medical marijuana providers could “file lawsuits against operators who label and advertise marijuana as 'medicine' because FDA has not designated it as such.” Since HHS has jurisdiction over Medicare and Medicaid, an HHS that is strongly opposed to pot could also theoretically “freeze or limit reimbursements to physicians because of their participation in medical marijuana programs.”

So far, HHS hasn't pushed this issue. But “if Price seeks to test the waters in this policy space, it could have a freezing effect on doctors' willingness to recommend marijuana,” Hudak said.

Kevin Sabet of the group Smart Approaches to Marijuana, an anti-legalization group, called the Price pick “encouraging,” saying “HHS plays a big role in drug prevention and I think that what we need is more awareness and prevention around marijuana.”

Hudak says that beyond policy specifics, “activist cabinet members could work not just to change policy but use their bully pulpits to change public opinion.” He noted that Cabinet appointees did this on drug policy in the past, particularly in the '70s and '80s. For instance, Ronald Reagan's attorney general, Edwin Meese, launched a nationwide campaign against marijuana growers, calling it “a gateway narcotic.”

Depending on the Trump administration's preferences, “an anti-marijuana battle for hearts and minds could once again be part of the official position of the US government.”