In Ten States, Millions of Americans Are Directly Voting On Abortion Access

Millions of voters across ten states will be directly weighing in on abortion through ballot initiatives come Election Day on Nov. 5—in what has become a historic push by reproductive healthcare advocates to reverse the impacts of overturning Roe v. Wade.

The 2024 campaign cycle, the first presidential race since the Dobbs decision upended federal protections for abortion, has been punctuated by reproductive freedom.

Republicans, including former president Donald Trump and his running mate JD Vance, have been attempting to appeal to the majority of voters that support access to abortion by rewriting their histories of restricting reproductive freedoms.

High-profile Democrats, including Vice President Kamala Harris, have been speaking about abortion in starker terms than ever before. (Lest we remember the website dedicated to President Joe Biden not saying the word “abortion.”)

Nationally, Americans have shared personal stories through social media, in political advertisements, and on courtroom floors about their reproductive healthcare needs, their past pregnancy-related traumas, and how the coordinated effort to roll back protections has impacted their lives and livelihoods.

For millions of voters going to the polls this week, abortion is the number one issue on their minds. According to recent polling from the Kaiser Family Foundation, four in ten women voters under 30 now say abortion is their most important issue. And, this is true in swing states, too. A New York Times/Siena College set of polls of registered voters in seven battleground states from August found that for women younger than 45, abortion had overtaken the economy as the single most important issue to their vote.

These 11 ballot measures across 10 states—Nebraska has two dueling questions for voters to weigh in on—are historic. There has never been this many simultaneous chances for voters to have their say on reproductive freedoms. The referendums differ in language, exceptions, and scope of protections. Some, like the ones in Colorado and New York, seek to deepen and secure established rights to abortion. While others, like those on the ballots in Florida and Arizona, hope to reverse bans made possible because of Dobbs.

Since five Supreme Court justices—three of whom Trump appointed—voted to overturn Roe in 2022, about half of all states currently have stricter restrictions on abortion than they did pre-Dobbs. Thirteen states outright ban abortion; four states have six-week bans, before many people even know they’re pregnant; and out of the states with abortion bans or gestational limits, ten do not have exceptions for pregnancies resulting from sexual assault.

These statewide bans have resulted in an America where 21% of women ages 18-49, who live in states with bans, say that they or someone they know has struggled to access an abortion because of those restrictions, according to polling from KFF.

As ProPublica has reported, lack of access to reproductive care paired with confusion around who qualifies for slim medical exceptions to abortion bans has culminated in the known deaths of multiple women. Just this week, the ProPublica team told the story of Nevaeh Crain, a pregnant teenager from Texas who died after screening positive for sepsis and being sent back home because her fetus still had a heartbeat.

It’s unclear how many unnamed, unreported women have also died due to lack of reproductive medical care post-Dobbs.

The majority of the ballot measures include protections similar to Roe, or up until fetal “viability”—which is typically defined as around 24 weeks. Though, as the American College of Obstetricians and Gynecologists has said, “The concept of viability of a fetus is frequently misrepresented or misinterpreted based on ideological principles. This perpetuates incorrect and unscientific understandings of medical terms and leads to interference in the practice of medicine.”

For abortion rights advocates, getting these initiatives in front of voters and dispensing information about them hasn’t always been easy. Disinformation campaigns across the country have misrepresented these measures, and anti-abortion groups have spent large sums of money to see them fail.

In the coming days, including on election night, I’ll be keeping tabs on these measures, detailed, in part, below.

Arizona

Abortion is banned in Arizona at 15 weeks, and there are no exceptions for rape or incest. Throughout the past two years, the state has oscillated between these present restrictions and a complete ban on abortion from 1864, while Arizona was still a territory.

The swing state’s abortion ballot initiative, Proposition 139, would create “a fundamental right to abortion under Arizona’s constitution” until fetal viability, defined as “the point in the pregnancy when, in the good-faith judgment of a treating health care professional, the fetus has a significant likelihood of survival outside the uterus.” Abortion would also be permitted after this point when necessary to protect the life or the physical or mental health of the pregnant individual.

The proposition also carves out protections for anyone who assists someone in seeking an abortion. Dawn Penich, the communications director for Arizona for Abortion Access, the organization behind Prop 139, said the group turned in the highest number of signatures by a citizens initiative in state history: totaling more than 820,000.

According to a NYT/Siena College poll from September, 58% of respondents said they would vote yes on Prop 139. Voters driven to the polls by the abortion ballot initiative could benefit Democrats up and down the ballot.

Colorado

Colorado’s Proposition 79, called the Right to Abortion and Health Insurance Coverage Initiative, would enshrine the right to abortion in the Colorado Constitution and repeal the current ban on state and local funding for abortion services.

It needs at least 55% to pass.

Abortion is not restricted based on gestational weeks in the Centennial State. In 2022, Democrats in the state passed a bill guaranteeing abortion access in state law. “But,” The Colorado Sun reports, “that measure could be overturned or undermined by a simple majority vote in the General Assembly, or by the passage of a statutory ballot measure, which also only requires a simple majority to pass.”

If voters pass Prop 79, the constitutional right to abortion could only be removed if 55% of people in the state voted to do so.

Florida

Florida’s current six-week abortion ban is one of the strictest in the nation, starting the clock on the first day of the last menstrual period, not from conception. This ban, which took effect in May, replaced a 15-week ban from July of 2022 and decimated access in the region.

Florida’s Amendment 4, or the Right to Abortion Initiative, seeks to ensure that “No law shall prohibit, penalize, delay, or restrict abortion before viability or when necessary to protect the patient’s health, as determined by the patient’s healthcare provider.”

The amendment would not do away with the “Legislature’s constitutional authority to require notification to a parent or guardian before a minor has an abortion.”

In late August, Trump, who votes in Florida, said in an interview with NBC News that the current ban is “too short.” When pressed on how he plans to vote on the ballot initiative, he responded, “I am going to be voting that we need more than six weeks.” “It has to be more time,” he said.

Then, Conservatives got mad at his supposed stance, and just a day later, Trump reneged.

“So I think six weeks, you need more time than six weeks. I’ve disagreed with that right from the early primaries when I heard about it, I disagreed with it,” Trump told Fox News. “At the same time, the Democrats are radical, because the nine months is just a ridiculous situation where you can do an abortion in the ninth month. … So I’ll be voting no for that reason,” he continued, echoing a common abortion myth.

Maryland

Question 1 in Maryland, or the Right to Reproductive Freedom Amendment, seeks to establish a “right to reproductive freedom” in the Maryland Constitution’s Declaration of Rights, including “the ability to make and effectuate decisions to prevent, continue, or end one’s own pregnancy.”

Maryland has broad protections for abortion, allowing access to care later in pregnancy in the case of danger to the person’s life and health or fetal anomaly. In 2023, Maryland “enacted interstate shield laws protecting providers, patients, and people who help others access abortion from professional licensure consequences, the reach of out-of-state investigations and legal actions, and the disclosure of information,” per the Center for Reproductive Rights.

Missouri

Missouri bans virtually all abortions and criminalizes those who perform abortions deemed not necessary emergencies with up to 15 years in prison. There are no exceptions for rape or incest.

Missouri’s Right to Reproductive Freedom Initiative, or Amendment 3, reads, in part, “The Government shall not deny or infringe upon a person’s fundamental right to reproductive freedom, which is the right to make and carry out decisions about all matters relating to reproductive health care, including but not limited to prenatal care, childbirth, postpartum care, birth control, abortion care, miscarriage care, and respectful birthing conditions.”

The amendment also includes a “Fetal Viability” clause, with exceptions for the life or health of the pregnant person.

In September, the narrowly divided Missouri Supreme Court voted 4-3 to keep the abortion initiative on the ballot after a group of anti-abortion lawmakers and activists challenged its legal standing.

Nebraska

Nebraska is the only state to have two rivaling abortion ballot initiatives this year, Initiative 434 which seeks to limit access, and Initiative 439 which aims to broaden it.

The former, the Prohibit Abortions After the First Trimester Amendment, hopes to add this language to the state’s constitution: “Except when a woman seeks an abortion necessitated by a medical emergency or when the pregnancy results from sexual assault or incest, unborn children shall be protected from abortion in the second and third trimesters.”

The latter, the Right to Abortion Initiative, aims to “amend the Nebraska Constitution to provide that all persons shall have a fundamental right to abortion until fetal viability, or when needed to protect the life or health of the pregnant patient, without interference from the state or its political subdivisions.”

The initiative defines “fetal viability” as “the point in pregnancy when, in the professional judgment of the patient’s treating health care practitioner, there is a significant likelihood of the fetus’ sustained survival outside the uterus without the application of extraordinary medical measures.”

Nebraska prohibits abortion at 12 weeks, with stated exceptions for rape, incest, or “to avert her death or to avert serious risk of substantial and irreversible physical impairment of a major bodily function.”

Nevada

Nevada’s Question 6, titled the Right to Abortion Initiative, would establish a state constitutional right to an abortion, while allowing the government to regulate after the point of “fetal viability,” around 24 weeks. The initiative includes exceptions that “protect the life or health of the pregnant patient.”

In Nevada, abortion is currently legal up until this point. The ballot initiative would further secure these protections.

New York

In New York, Proposal 1, or the Equal Protection of Law Amendment, would add a clause into the state’s Bill of Rights, ensuring “against unequal treatment based on ethnicity, national origin, age, disability, and sex, including sexual orientation, gender identity and pregnancy.”

The initiative would also add protections “against unequal treatment based on reproductive healthcare and autonomy.”

In the Empire State, abortion is legal up to and including 24 weeks. After that point, there are exceptions for fetal viability or to protect the pregnant person’s life or health. Providers cannot be criminally prosecuted for performing abortions outside of this window, and minors do not need their parents’ permission to get birth control, abortion, prenatal care, or access to other reproductive healthcare.

Across what is considered a deep-blue state, the ballot initiative has been turned into a referendum on parental rights by anti-trans activists who seek to thwart the amendment.

As CBS reports, “The Coalition to Protect Kids is making an effort to dissuade people from voting yes on Prop 1, saying it opens the door for men to use women’s bathrooms, transgender adolescents to compete on sports teams that align with their gender identities, and minors to seek abortions without parental consent.”

South Dakota

South Dakota bans abortion in practically all cases, with no exceptions for rape or incest. (There is a “life of the mother” exception.) Those who perform abortions are “guilty of a Class 6 felony,” per state law.

The state’s Constitutional Amendment G, or the Right to Abortion Initiative, “establishes a constitutional right to an abortion and provides a legal framework for the regulation of abortion,” per the ballot language.

This legal framework is separated by trimesters.

In the first trimester, “a pregnant woman’s decision to obtain an abortion may not be regulated nor may regulations be imposed on the carrying out of an abortion.” In the second trimester, the state could regulate abortion in instances that are “reasonably related to the physical health of the pregnant woman.” And in the third trimester, the amendment allows “the regulation or prohibition of abortion except in those cases where the abortion is necessary to preserve the life or health of the pregnant woman.”

This decision, the initiative clarifies, “must be determined by the pregnant woman’s physician according to the physician’s medical judgment.”

Montana

Montana’s Right to Abortion Initiative, also called CI-128, “will decide on whether to affirm a 1999 state Supreme Court ruling that protected the right to abortion up until fetal viability,” as reported by MSNBC. “State courts have blocked several anti-abortion bills in the past, citing the 1999 ruling, and abortion rights advocates are hoping to enshrine that right in the state constitution.”

In Montana, abortion is available up until “fetal viability.”

The constitutional amendment, per the initiative’s language, also seeks to prevent “the government from penalizing patients, healthcare providers, or anyone who assists someone in exercising their right to make and carry out voluntary decisions about their pregnancy.”