Where Marijuana Is the Doctor's Orders, Will Insurers Pay?

Early this year, a disabled former automobile body worker named Greg Vialpando explained to lawmakers in New Mexico how medical marijuana helped his chronic back pain.

State legislators were considering a bill backed by workers’ compensation insurers that would have exempted them from paying for medical marijuana. But Mr. Vialpando and another patient described how smoking the drug let them escape years of stupor caused by powerful prescription narcotic drugs known as opioids.

The lawmakers ended up dropping the bill, and Mr. Vialpando’s expenses for buying marijuana are covered by insurance.

“I would recommend that people use medical marijuana over opioids any day,” Mr. Vialpando, 58, said in a telephone interview.

For businesses and insurers, a string of ballot victories this month for marijuana advocates are adding to an intensifying conundrum about the drug and issues such as insurance coverage, employee drug testing and workplace safety.

Voters in California, Massachusetts,...

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