Nebraska’s voter-approved medical marijuana laws have survived one of their most serious legal challenges after the Nebraska Supreme Court unanimously upheld the petitions that placed legalization and regulation before voters in 2024. In its September 4, 2026 decision in Kuehn v. Evnen, the court affirmed a Lancaster County District Court ruling that opponents failed to prove enough petition signatures were invalid to disqualify either measure. The decision leaves intact both the Nebraska Medical Cannabis Patient Protection Act, which protects qualifying patients and caregivers under state law, and the separate law establishing the Nebraska Medical Cannabis Commission and regulated commercial system.
The ruling is particularly significant because medical marijuana had already received overwhelming support at the ballot box. Initiative Measure 437, covering patient protections, received 637,126 votes in favor and 259,643 against—about 71 percent approval. Initiative Measure 438, establishing the regulatory framework, received 600,481 votes in favor and 291,867 against—about 67 percent approval. The measures became Nebraska law after the election, but litigation over how their petitions had been circulated and notarized continued for nearly two years.
The Court Rejected an Attempt to Disqualify Thousands of Petition Signatures
The case was brought by former Nebraska state Sen. John Kuehn, who challenged the legal sufficiency of the two petitions before the November 2024 election. Nebraska Secretary of State Bob Evnen initially certified the measures for the ballot but later filed his own cross-claim questioning their validity after an investigation by Attorney General Mike Hilgers’ office raised allegations of circulator misconduct and improper notarization. To qualify, each initiative needed at least 86,499 valid statewide signatures and had to satisfy geographic distribution requirements in at least 38 of Nebraska’s 93 counties. The Secretary of State initially verified 89,962 signatures for the legalization petition and 89,856 for the regulatory petition.
After a four-day trial in late 2024, Lancaster County District Judge Susan Strong agreed that some petition pages contained defects and that certain signatures should lose their presumption of validity. But she rejected the challengers’ effort to extend those defects across thousands of otherwise unproven petition pages. Strong ultimately determined that the legalization petition still had 89,251 valid signatures and the regulatory petition had 89,030—both comfortably above the 86,499 threshold. Because the challengers remained thousands of signatures short of invalidating either initiative, she ruled that a second phase of trial requiring campaign sponsors to individually “rehabilitate” contested signatures was unnecessary. The Supreme Court has now affirmed that conclusion.
Improper Notarization Did Not Automatically Taint Every Petition Page
One of the most consequential questions in the appeal concerned whether misconduct by a petition notary on one page should undermine every page handled by that same notary. Kuehn and state officials relied heavily on a 1919 Nebraska precedent, Barkley v. Pool, involving fraud by petition circulators. They argued that when a notary was shown to have improperly notarized one or more petition pages, all signatures on every page associated with that notary should lose their presumption of validity unless campaign organizers could prove them individually.
The Supreme Court rejected that broad interpretation. Chief Justice Jeffrey Funke’s opinion distinguished circulator fraud—where someone collecting signatures may falsely swear that signatures were gathered properly—from ordinary notarial defects. A notary verifies that a person appeared, affirmed the document and signed it; the notary is not personally testifying to the truth of every statement contained in the circulator’s affidavit. The court therefore concluded that Barkley did not require wholesale invalidation merely because a notary incorrectly handled some pages. Similar reasoning from courts in North Dakota and Missouri supported the principle that specific notarial irregularities should not automatically nullify the lawful signatures of unrelated voters.
That does not mean the court declared notary misconduct irrelevant. Justice William Cassel, joined by Justice John Freudenberg, wrote separately to emphasize that sufficiently widespread or intentional notarial involvement in a fraudulent scheme could justify shifting the burden to petition sponsors in a future case. The deciding factor here was the evidence: the trial judge had not found the irregularities sufficiently pervasive to justify invalidating thousands of additional signatures, and the Supreme Court saw no basis to overturn that conclusion.
The Fifth Amendment Arguments Also Failed
The litigation became more complicated because several people involved in the petition campaign invoked their Fifth Amendment right against self-incrimination while testifying. Kuehn and state officials argued that the judge should have drawn negative conclusions from those refusals to answer questions and used those inferences to invalidate additional petition pages. In civil litigation, courts can sometimes draw an adverse inference when a party invokes the Fifth Amendment, unlike in criminal trials where exercising the right cannot be treated as evidence of guilt.
The Nebraska Supreme Court did not decide that adverse inferences can never be used in such a situation. Instead, it held that even assuming the district court possessed that authority, drawing an adverse inference was discretionary rather than mandatory. The trial judge had considered the ongoing criminal investigation and the unusual circumstance that the Attorney General’s Office was simultaneously involved in investigating campaign workers and representing the Secretary of State in the civil litigation. Under those circumstances, the Supreme Court ruled that Strong acted within her discretion when she declined to turn witnesses’ Fifth Amendment invocations into evidence invalidating additional signatures.
The numerical margin ultimately made that legal question less decisive than it might initially appear. The high court said that even if some additional specifically challenged pages had been excluded, the number of affected signatures remained too small to reduce either petition beneath the constitutional requirement. In other words, the challengers did not merely lose because of a technical interpretation of notary law; the court concluded that the additional defects they identified still would not have changed whether the initiatives qualified for the ballot.
Nebraska Voters Had Already Approved the Measures by Large Margins
The ruling closes another chapter in a medical marijuana campaign that has stretched across several election cycles. Nebraska advocates previously succeeded in collecting enough signatures for a medical cannabis constitutional amendment in 2020, only for the Nebraska Supreme Court to remove the proposal from that year’s ballot. In State ex rel. Wagner v. Evnen, the court concluded that the proposal violated Nebraska’s single-subject rule because patient use, private commercial production and several other regulatory subjects had been combined into one constitutional amendment.
Advocates eventually responded by separating patient protection from commercial regulation. That strategy produced the two 2024 initiatives at the center of the new ruling. Measure 437 dealt with the right of qualifying patients and caregivers to possess and use cannabis for medical purposes, while Measure 438 created the regulatory system governing businesses. Splitting the issue into separate statutory measures allowed Nebraska voters to consider medical use and the commercial framework independently. Both passed with more than two-thirds support.
The result also makes the September 2026 ruling different from the 2020 case. This time the Supreme Court was not deciding whether the substance of the cannabis measures improperly combined multiple subjects. It was reviewing whether enough legally valid signatures supported putting the measures before voters in the first place. Its answer was unequivocal: the lower court had not committed reversible error, and the petitions remained legally sufficient.
What Nebraska’s Medical Marijuana Law Actually Allows
Nebraska’s patient-protection law is narrower than recreational legalization. Under current statute, a qualified patient with a written recommendation from a licensed health care practitioner may possess up to five ounces of cannabis for alleviating a medical condition, its symptoms or treatment-related side effects. Adults qualify with a written recommendation, while patients younger than 18 additionally need permission from a parent or legal guardian. A caregiver may possess and acquire the allowed amount on behalf of the patient. Protected conduct is exempt from state and local penalties and from Nebraska’s Uniform Controlled Substances Act.
Nebraska law defines a written recommendation as a signed declaration that, in the health care practitioner’s professional judgment, the potential benefits of cannabis outweigh the potential harms for the patient’s condition. The authorization can remain valid for two years unless the practitioner specifies a different period. This means Nebraska operates through medical recommendations rather than treating cannabis exactly like a conventional FDA-approved prescription drug.
The companion regulation law gives the Nebraska Medical Cannabis Commission exclusive authority over the possession, manufacturing, distribution, delivery and dispensing of medical cannabis by registered businesses. The commission was created from members of the Nebraska Liquor Control Commission, with authority for the governor to appoint additional members.
Nebraska’s Regulated Cannabis System Is Already Moving Forward
The Supreme Court decision arrives after Nebraska’s program has progressed well beyond the original election. The Medical Cannabis Commission now has permanent regulations that were approved by Attorney General Hilgers on June 30 and Gov. Jim Pillen on July 1, 2026. Those rules govern areas such as cultivation, manufacturing, dispensaries, security, patient access and licensing. The commission has also moved into a second round of rulemaking to establish new application and renewal fees after the Legislature authorized fees of as much as $50,000.
The supply chain has begun taking physical shape as well. In June, commissioners ratified an inspection allowing a licensed cultivator to begin growing the first state-authorized cannabis plants, and applications for product manufacturers subsequently opened. Current rules place limits on the number of establishment licenses and impose extensive security and tracking requirements. The commission is now considering additional regulatory amendments and has another public meeting scheduled for September 14.
That makes the Supreme Court ruling more than symbolic. Reversing the lower court could have threatened a system that has already required licensing decisions, regulatory work, business investment and state administrative spending. Affirming the petitions removes one major source of uncertainty just as the state attempts to move from voter authorization toward an operating medical-cannabis market.
Another Legal Challenge to Medical Cannabis Is Still Pending
The September 4 ruling does not resolve every legal challenge facing Nebraska medical marijuana. Kuehn filed a separate lawsuit, Kuehn v. Pillen, arguing that Nebraska’s medical cannabis laws conflict with federal controlled-substance law and that state taxpayer funds should not be spent implementing them. Lancaster County District Judge Susan Strong dismissed that case in June 2025 because Kuehn lacked standing rather than reaching the underlying federal-preemption argument.
Kuehn appealed, and the Nebraska Supreme Court heard oral arguments on April 27, 2026. According to the court’s own case summary, the appeal centers heavily on whether Kuehn has taxpayer or “great public concern” standing to sue, alongside his Supremacy Clause and separation-of-powers arguments. As of September 5, that case remains separate from the newly decided petition-signature dispute. The September 4 ruling therefore confirms that the initiatives were validly placed before voters; it does not yet constitute a Supreme Court ruling on every possible federal-law objection to Nebraska’s system.
That distinction is especially important for interpreting headlines saying the Supreme Court has “upheld legalization.” The court has unquestionably preserved the voter-approved laws against the petition challenge, but another lawsuit still seeks to attack their implementation on different constitutional grounds.
A Major Victory for Nebraska’s Medical Cannabis Program
For supporters, Kuehn v. Evnen removes a legal cloud that has hung over Nebraska medical marijuana since before voters cast their ballots. The court acknowledged that some genuine petition irregularities occurred, but it declined to transform isolated or specifically proven wrongdoing into automatic invalidation of thousands of signatures from voters who had not themselves been shown to have done anything improper. That approach ultimately preserved measures that were not only supported by enough valid petition signers but were later approved by roughly seven in ten Nebraska voters.
The decision also establishes an important boundary for future Nebraska initiative litigation. Proven circulator fraud can undermine signatures collected by that circulator, and serious evidence of systematic notarial fraud could potentially justify broader consequences. But courts will not automatically invalidate every petition page touched by a notary simply because separate pages contain defects. Challengers still need evidence connecting alleged misconduct to enough signatures to change the legal sufficiency of the petition.
For Nebraska patients and medical cannabis businesses, the immediate result is straightforward: Initiative Measures 437 and 438 remain law, the Medical Cannabis Commission remains intact, and implementation can continue. After years of unsuccessful ballot efforts, litigation and regulatory delays, the state’s highest court has now unanimously rejected the signature challenge that could have undone the entire 2024 election result. The remaining questions have shifted away from whether Nebraska voters validly enacted medical marijuana and toward how quickly the state can build the functioning system those voters approved.
