It looks like New York’s new medical program is showing a growing trend of medical marijuana laws that seem compassionate, but don’t let people grow or smoke the flowers of the cannabis plant.

It has been said, “As goes New York, so goes the nation,” a phrase which, in the grand scheme of nationwide efforts to reform marijuana laws, could indicate that cut-rate medicinal cannabis programs are destined to continue surfacing across the country—making a natural medicine too expensive for the average patient to afford.

Since New York officially launched its medical marijuana program six months ago, there has been a lot of concern that the state’s vision for marijuana medicine has made it next to impossible for almost everyone involved to reap any benefit. A recent report from the Drug Policy Alliance (DPA) has found that the majority of those currently enrolled in the program are confronted with too many barriers to even participate.

For starters, the report indicates that the restrictive nature of the Compassionate Care program—one that prohibits home cultivation and smokable marijuana—has made cannabis products so expensive that 77 percent of the patients allowed to purchase weed simply cannot afford to do it. To make matters worse, the DPA goes on to suggest that most patients are doomed long before they ever have a chance to step foot inside of a dispensary because less than one percent of doctors licensed to practice in the state of New York have been certified to provide medical marijuana recommendations for those with “severe, debilitating or life-threatening” conditions.

“More than half of patients and caregivers surveyed had not yet found a doctor to certify them, and among those, 3 out of 5 have been waiting for 3 to 4 months to locate a registered physician,” the report reads.

But even if a patient is fortunate enough to find a doctor to provide them with permission to use the program—and the patient has enough money in the bank to begin making monthly pot purchases—obtaining this medicine is not as easy as walking into the local Walgreens to get a prescription filled.

New York’s Compassionate Care law only designates five cannabis producers (a total of 20 dispensaries) to supply the entire state with medical marijuana products. Unfortunately, this means patients living in rural areas are sometimes forced to travel for several hours just to get their hands on the medicine they need. In fact, the DPA found that nearly 30 percent of the state’s registered patients and caregivers drive between one to five hours away from home just to get to a dispensary.

The most frightening element of New York’s program is the influence it has—and will likely continue to have—on other states interested in designing medical marijuana programs of their own.

Just last week, Ohio Governor John Kasich put his signature on a modest medical marijuana bill that seems to borrow elements of the Compassionate Care law in that it does not allow patients to cultivate or smoke marijuana. Instead, much like New York, the program will force qualified patients to spend hundreds, potentially even thousands, of dollars a month to buy vapors, oils and some edibles from an undetermined number of dispensaries.

The same racket has been going down for nearly a year in Minnesota—no smoking, no home grows and a limited number of qualified conditions—that has pressured some desperate patients to pack up and move to more liberal, legal states in order to get medical marijuana without being buried alive by the financial strain that comes with purchasing pharmaceutical derivatives of the cannabis plant. Others have simply continued to purchase weed through the black market.

Even long-time cannabis advocates believe that New York could serve as a blueprint for lawmakers all across the nation when it comes time to develop their state’s medical marijuana programs. Earlier this year, Keith Stroup, founder of the National Organization for the Reform of Marijuana Laws, said that because of New York’s influence on national policy, more states would follow in its footsteps—a statement that solidifies the latest trend of weak medicinal cannabis programs.