There Are More Abortion Rights Ballot Measures Than Ever Before

Eleven abortion referendums will be in front of voters in 10 states this Election Day — the largest number of pro-choice amendments the country has ever seen during a single election cycle.

From red states like Missouri and South Dakota to blue states like New York, the abortion rights ballot measures could have a monumental impact on access throughout the country. Over 20 states have enacted abortion bans since the Supreme Court repealed federal abortion protections in 2022. Citizen-led initiatives, like most of this year’s abortion rights measures, have become the response to many of the near-total abortion bans passed by Republican-controlled state legislatures.

“This is a public health crisis that we have right now,” said Chris Melody Fields Figueredo, executive director at the Ballot Initiative Strategy Center, who has worked with campaigns in all 10 states where an abortion rights amendment is in play. “The citizens, in the absence of their local elected officials, are addressing it. They’re taking power into their own hands.”

In 2022, there were six ballot measures addressing abortion, which at the time was the most in a single year. Voters protected abortion care in every state it was on the ballot during that election cycle, including in deeply Republican states like Kentucky. Ohio, a state with a long and extreme anti-abortion history, also voted to codify abortion rights into its state constitution just last year.

This year’s ballot measures range in their approaches to and levels of abortion protections. Nebraska will have two competing abortion measures, one to restrict access and one to expand. Maryland, New York and Colorado are all seeking to codify abortion protections throughout pregnancy — exceptions to the rest of the measures, which would primarily enshrine access until viability or around 24 weeks. Colorado’s Amendment 79 would also allow the use of public funds for abortion care. Missouri’s Amendment 3 would restore abortion access until viability and protect women from being prosecuted for pregnancy outcomes like miscarriage and stillbirth — a particularly progressive measure in a notoriously anti-abortion state.

If passed, most amendments would generally go into effect shortly after Election Day or at the start of 2025. Measures in Montana and South Dakota would tentatively go into effect in July 2025, while Nevada’s may not until 2026. There will be litigation in any state that passes a pro-choice measure; this is likely the time when states will bring legal challenges against successful ballot initiatives and fight to keep other abortion regulations like waiting periods and other long-standing targeted restrictions on abortion providers.

The historic number of abortion rights measures is emblematic of just how politically prominent abortion care has become. And despite conservatives who claim to want to “leave abortion to the states” since Roe fell, many did everything in their power to stop voters from weighing in on abortion rights measures.

“This is not just a reproductive freedom issue, it’s also a democracy issue,” Fields Figueredo said. “It’s about who has power and who has the determination to control what happens to their body.”

Arizona’s Proposition 139 seeks to enshrine access to abortion up until fetal viability, or around 24 weeks, into the state constitution. If passed, the state of Arizona will not be able to limit access to abortion before viability unless the government “has a compelling reason and does so in the least restrictive way possible,” according to the measure. Under the amendment, also known as the Right to Abortion Initiative, abortions would be allowed after fetal viability only when the health or life of the pregnant person is at risk. The measure also bars future laws from punishing anyone who assists someone getting an abortion.

The state currently has a 15-week abortion ban in effect with no exceptions for rape or incest. Earlier this year, the Arizona state Supreme Court greenlit a near-total abortion ban that the Republican-controlled legislature voted to repeal.

The measure needs a simple majority to pass.

Colorado’s pro-choice amendment would create a constitutional right to abortion care throughout pregnancy and mandate that Medicaid and private insurance companies cover abortion care. Amendment 79, also known as the Right to Abortion and Health Insurance Coverage Initiative, would repeal a 1984 addition in the Colorado constitution which barred the use of public funds for abortion care.

The measure is distinct for two reasons. Nearly every other state where abortion is on the ballot is trying to enshrine access until fetal viability, not throughout pregnancy. Additionally, requiring that abortion care be a covered service under all health insurance plans is a step pro-choice groups have been pushing for for decades.

The state does not currently restrict abortion at any point in pregnancy, making it a refuge for those who need abortion care later in pregnancy. The measure needs at least 55% of the vote to pass.

Amendment 4 would restore abortion access until viability by adding language to the Florida constitution that states “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 ballot measure, also titled Amendment to Limit Government Interference with Abortion, does not change the state’s current law that requires parental consent for a minor to obtain an abortion.

Since the Supreme Court repealed Roe v. Wade in 2022, the state passed a 15-week abortion ban with no exceptions for rape or incest and then a six-week ban with exceptions for rape or incest. Under the leadership of Gov. Ron DeSantis (R), Florida has become one of the most extreme anti-abortion states in the country. If voters restore abortion access until viability, it would reestablish Florida as a critical safe haven in the Southeast, where most states have near-total abortion bans.

Florida has a supermajority requirement for citizen-led ballot initiatives, meaning the amendment needs to get at least 60% of the vote to pass.

Maryland’s Question 1 guarantees the right to reproductive freedom, defined in the measure as “the ability to make and effectuate decisions to prevent, continue, or end one’s own pregnancy.” The amendment specifies that the government cannot “directly or indirectly, deny, burden, or abridge the right unless justified by a compelling State interest achieved by the least restrictive means.”

The Right to Reproductive Freedom Amendment would codify Maryland’s current law, which allows access to abortion care at any point in pregnancy and has made the state a safe haven for abortion access. It’s an exception to most other pro-choice measures on the ballot this year because it enshrines abortion access throughout pregnancy without limits. Colorado and New York are the only two other states where pro-choice groups are hoping to codify abortion access throughout pregnancy.

The amendment would pass with a simple majority.

Amendment 3 would codify the right to reproductive freedom, including abortion access until fetal viability, into the Missouri constitution. The measure would protect the right to make decisions about other reproductive health issues including birth control, prenatal care, childbirth, postpartum care, miscarriage care and “respectful birthing conditions.” The Right to Reproductive Freedom initiative states plainly that, if passed, Missourians cannot be prosecuted for their pregnancy outcomes including miscarriage, stillbirth and abortion.

The initiative is extremely progressive for a deep-red state that has such a long anti-abortion history. The state only had three abortion clinics in 2017, and the last clinic closed shortly after Roe fell. Missouri currently has a near-total abortion ban with an exception to save the life of a pregnant person.

If the amendment passes, it would be a huge win for reproductive rights groups, and Missouri could become one of the few Midwest states with abortion access. But the state would still have a lot of work to do since many of the prior abortion regulations, such as Missouri’s 72-hour waiting period and ban on telemedicine, would need to be challenged in court.

The measure needs a simple majority to pass.

Montana’s Right to Abortion Initiative would enshrine the “right to make and carry out decisions about one’s own pregnancy, including the right to abortion” until fetal viability. The government could regulate abortion after viability except in cases where abortion care is needed to protect the life or health of the pregnant person. The measure also protects Montanans from being prosecuted for “actual, potential, perceived or alleged pregnancy outcomes,” as well as protecting anyone who helps someone seeking abortion care.

The amendment would codify the state’s current abortion law, which restricts abortion care after 24 weeks. Montana voters need a simple majority to pass the amendment.

Nebraska will have two ballot measures addressing abortion, one in favor of abortion rights and one against. It’s the first time competing abortion measures will be on a state ballot since the Supreme Court repealed Roe.

The pro-choice amendment, also known as the Right to Abortion Initiative, would enshrine abortion access until fetal viability into the state constitution. The measure opposed to abortion rights seeks to codify the state’s current 12-week abortion ban, or a ban on abortion after the first trimester. The anti-choice initiative does have exceptions for rape, incest and in cases of a medical emergency.

Both amendments need a simple majority to pass.

Nevada’s Question 6 would enshrine the right to abortion access until viability and when necessary to protect the health or life of the pregnant person throughout pregnancy. The amendment states that the right to abortion until viability “shall not be denied, burdened, or infringed upon unless justified by a compelling state interest that is achieved by the least restrictive means.”

The measure, which needs a simple majority to pass, would enshrine Nevada’s current abortion law into the state constitution.

Proposal 1 would amend New York’s Equal Rights Amendment to include protections for “pregnancy, pregnancy outcomes, and reproductive healthcare and autonomy” which would codify abortion protections throughout pregnancy. While it does not explicitly state abortion protections, including protections for pregnancy outcomes and reproductive decisions in the state constitution would safeguard abortion access in the state.

The state’s Equal Rights Amendment currently criminalizes the denial of rights to people based on “race, color, creed or religion.” Proposal 1 would add ethnicity, national origin, age, disability, sexual orientation, gender identity and gender expression, as well as reproductive health outcomes.

The initiative is noteworthy because, if passed, it will be the first equal rights amendment to include protections for pregnant people and pregnancy outcomes. Abortion is currently legal in New York until viability. Expanding the equal rights amendment to include pregnant people would codify the current law.

South Dakota’s Amendment G breaks down abortion protections by trimesters, similar to the 1973 Roe v. Wade decision. The initiative would codify abortion protections until 13 weeks or through the first trimester, and then allow the government to regulate abortion in the second trimester “only in ways that are reasonably related to the physical health of the pregnant woman.” In the third trimester, the state could regulate or ban abortions except in instances when the health or life of the pregnant person is at risk.

If the measure passes it would be a huge win for abortion rights groups because the state currently has a near-total abortion ban with no exceptions other than to save the life of a pregnant person. Pro-choice groups would still have a long way to go in restoring abortion access in the state, however. Even before Roe fell, South Dakota only had one abortion clinic left and zero in-state providers, and some regulations — like the state’s 72-hour waiting period before being able to access care — would likely need to be challenged in court.

The initiative needs a simple majority to pass.