Governor Cuomo is expected to flesh out his plan to legalize medical marijuana by fiat during the State of the State speech on Wednesday. The initiative would utilize a loophole in the public health law to allow 20 hospitals to prescribe cannabis to “patients who are involved in a life-threatening or sense-threatening situation." Yet the medical facilities that are supposedly going to distribute the drug have been left in the dark, and the provision may be too narrow to help patients who need cannabis to live normal, productive lives.

"Has anyone from the Cuomo administration called the 20 hospitals and told them that they were going to be breaking federal law?" Allen St. Pierre, the executive director for the National Organization for the Reform of Marijuana Laws said. "A lot of people were surprised that the governor jammed the legislature like this. It's fascinating."

An official told the Times that while the language in the public health provision is fairly explicit, it would not exclude patients with multiple sclerosis, cancer in remission, or pediatric illnesses. The ultimate interpretation of the provision will be up to the Health Department, which will hold public hearings before making a final decision.

Mason Tvert, a spokesman for the Marijuana Policy Project, said in a statement that while his organization was "glad" that Cuomo had made an about-face on medical marijuana, "The nature of his proposal suggests he still has a little way to go, as it is unlikely it will benefit patients anytime soon."

"If the governor and legislators agree that medical marijuana can help seriously ill people live better lives, there's no reason why they shouldn't adopt a system that will help them immediately," Tvert said.

St. Pierre speculates that Cuomo's decision is partly rooted in the state legislature's obstinacy in passing marijuana law reform, but he also described it as the work of a shrewd politician who wants to show that he can deliver results on an issue that's overwhelmingly supported by voters, an essential part of any presidential candidate's resume.

"If you're gonna run left of center and you are against medical marijuana, you're braindead," St. Pierre said. "He's such a fastidious, lawyer type, that rather than allow the process to work out in a messy, democratic, prolonged, fashion, he grabbed the brass ring and just declared it."

New Jersey Governor Chris Christie has attempted to cobble together a complex set of regulations for his state's medical marijuana program, which resulted in confusion and severe delays (and worse) for patients. St. Pierre applauded Cuomo for taking leadership on the issue, but sees similar problems in store for New York.

"New Jersey, New York, Connecticut, they make up the triumvirate of the guarded, conservative approach to what they perceive is a chaotic distribution system on the west coast," St. Pierre says. "If you're sick, dying, or sense-threatened in the tri-state area, you're probably going to be using marijuana illegally for some time to come."