Four years after the Supreme Court overturned the federal right to an abortion with the Dobbs decision, access to the procedure remains a critical matter for voters across the country. Abortion rights advocates are hoping that abortion-related ballot measures in four states will inspire voters to turn out in the crucial midterm elections—and support candidates in favor of protecting abortion access.
The four states considering such ballot measures are Idaho, Missouri, Nevada, and Virginia. The initiatives in Nevada and Virginia would not change existing law but would amend the constitution to enshrine abortion protections. The Idaho ballot measure would reverse the state’s strict abortion ban. Meanwhile, the Missouri initiative is attempting to undo protections approved by voters as a constitutional amendment in 2024.
Since the Supreme Court overturned Roe v. Wade in 2022, 17 states have put forth abortion-related ballot measures. In 2022 and 2023, every state that voted on these measures protected access to abortion. Voters in seven out of the 10 states considering abortion-related ballot measures in 2024 supported protecting abortion rights. But even the failure of ballot measures did not necessarily translate to lack of support: In Florida, an initiative to protect abortion rights received 57 percent of the vote, which did not clear the state’s 60 percent threshold for adding a state constitutional amendment.
“We’ve seen time and time again in states across the country that voters do turn out en masse to support abortion rights ballot measures. They have shown us that when they have a chance to change their state laws and support abortion access, they will take it,” said Sarah Standiford, national campaigns director at the Planned Parenthood Action Fund.
Control of Congress is up for grabs in this year’s elections. Democrats are favored to take the House of Representatives and have a shot at winning the Senate, as well. (The latest analysis from the Cook Political Report says that Democrats retaking the lower chamber is a “done deal” and assesses the chance of seizing the upper chamber as “very realistic.”) But the downballot contests are key where reproductive rights are concerned. State legislatures and gubernatorial races are perhaps even more crucial to ensuring abortion access. Since the Dobbs decision kicked the question of abortion rights to states, they have become the primary battlegrounds on the issue. Abortion rights advocates believe that ballot measures may help juice turnout in these states, but the challenge is ensuring that voters also back their preferred candidates.
“The ballot measures are a tremendous tool in our arsenal here, in order to protect and expand access, but it’s imperative that people are also voting their values up and down the ballot, and and voting to elect people to state office that are going to carry out and enforce the will of the voters by implementing these amendments in the appropriate way,” said Ryan Stitzlein, vice president of political and government relations at Reproductive Freedom for All, an abortion rights organization that launched a $23.5 million voter mobilization campaign earlier this year.
Support for abortion does not necessarily translate to support for Democratic candidates. Of the seven states that approved ballot measures supporting abortion rights, four supported Trump in the 2024 election. Moreover, in Montana and Missouri, politicians who oppose abortion rights were elected governor.
A recent paper by scholars at the University of Richmond and Texas Christian University found that abortion ballot measures aided Democrats in 2022—but two years later, they benefited Republican candidates. The researchers concluded that the spillover effects benefiting Republicans were a result of moderate voters who supported expanding abortion access while also voting for GOP candidates.
“In 2024, moderate voters who would have otherwise voted for Democratic candidates to protect abortion rights instead voted to protect abortion rights on the ballot measure while also voting for Republican candidates to align with their other policy preferences,” the report authors wrote.
Still, voters might now appreciate the stakes of electing candidates who support abortion access. A 2025 poll by the public opinion firm PerryUndem found that 46 percent of voters said they would be more likely to vote for a candidate who supports abortion rights, including 45 percent of independent voters. (Forty-one percent of independent voters said it would not affect their vote at all.) Another 2025 survey from Navigator Research found that majorities of voters reported they probably or definitely could not support candidates who are in favor of banning or restricting access to abortion and contraceptives.
Linking politicians to their positions on abortion is a critical challenge for Nevadans campaigning to oust current Republican Governor Joe Lombardo from office. Although Lombardo signed abortion protections into law in 2023, critics point to his personal opposition to abortion and unwillingness to say whether he supports the amendment as proof that he cannot be trusted to protect access. Nevadans for Reproductive Freedom recently launched a $1 million digital ad campaign in support of the amendment, which also highlights Lombardo’s previous comments opposing abortion. Separately, Planned Parenthood Votes is also investing $1.2 million in ads slamming Lombardo.
Krystal Ortiz, campaign manager for Question 6 at Nevadans for Reproductive Freedom, expects that “yes” votes for the ballot initiative will likely outperform Democratic candidates, but that’s because it’s an issue that Nevadans overwhelmingly support. In accordance with Nevada law, voters must approve a citizen-initiated ballot initiative twice before it can be added to the state constitution. The measure enshrining abortion protections was passed with 63 percent of the vote in 2024, and is now on the ballot again.
Ortiz is focused on building on the work advocates did in 2026—they don’t need to get on the ballot this time, but they do need to remind voters what’s at stake, she said.
“One of the differences between 2026 and 2024 is that this year, we have even more proof that our rights are under attack,” Ortiz said, pointing to abortion bans in other states, as well as efforts by the Trump administration and GOP state attorneys general to limit access to the abortion medication mifepristone. “We’re reminding voters that we have been seeing these kinds of attacks all across the country, and that’s why we need this.”
Abortion rights advocates are also hopeful about the prospects of initiatives in Idaho and Missouri, which are both deeply Republican, even as the road to passage is bumpy. In Idaho, which has one of the strictest abortion bans in the nation, the GOP governor and attorney general succeeded in changing the language of the ballot measure to note that current law “preserves the life of preborn children by prohibiting abortion” with few exceptions. Because passage of the ballot initiative would mean establishment of statutory law and not a constitutional amendment, this measure could be repealed by the state’s conservative legislature even if it succeeds.
In Missouri, Republicans are attempting to sway voter sentiment by including language that would constitutionally ban gender transition care for minors—even though such surgeries and issuing new puberty blocker prescriptions have been illegal in the state since 2023.
Supporters of the amendment are highlighting the gender transition care aspect in their campaigning, and Stitzlein said that abortion rights advocates needed to convince voters that this measure is primarily an abortion ban.
“They’re not saying the word ‘abortion’ in all their paid media. They know that it’s because if they were honest about their intentions here, they would lose,” said Stitzlein. The amendment also shares the same name as the one that enshrined abortion rights two years ago: Where supporters needed to vote “yes” on Amendment 3 two years ago to protect access, they must vote “no” on Amendment 3 to do the same this year. The 2024 measure ensured the right to an abortion through fetal viability.
Even with the efforts to protect abortion access in red states under siege, advocates believe their campaigns will have long-term impact. Standiford said that, as someone who has long worked in abortion rights advocacy, she is very aware that victories can be temporary. Conversely, those wins can inspire voters to continue fighting because their actions at the ballot box result in immediate change. Even if rights are threatened, she argued, that will not depress the movement overall.
“What voters and supporters find energizing about it is they can translate their votes—especially on these constitutional amendment fights—immediately into protections for themselves and their families. And that is a really empowering place to be,” said Standiford.
