Each year, medical marijuana patients must pay a $100 fee to the state to obtain a medical marijuana certificate, and $25 per year for certificates for their caregivers. These fees — which amount to about $5.3 million in total each year — effectively, and unfairly, tax medical marijuana patients for access to their medication. No other medical treatment or therapy requires such fees or taxes and, unlike prescription drugs, medical marijuana is a cash-only market. It is not covered by insurance of any sort, so patients must bear the full cost out-of-pocket.