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Abortion advocates aim to outflank lawmakers using 2024 ballot measures
Read more Stateline coverage on how states are either protecting or curbing access to abortions.
Encouraged by six victories — and zero defeats — in this month’s midterm elections, abortion rights advocates are considering another round of ballot measures in 2024 that would enshrine reproductive freedom in state constitutions.
This time, they’re mostly aiming at states with tight abortion restrictions already on the books, hoping to outflank anti-abortion state lawmakers and courts that are out of step with most residents.
Based on the midterms, the presence of such initiatives on the ballot also could give a boost to Democratic candidates. Contrary to predictions, abortion was the top issue for a large percentage of voters, especially those in states where an abortion measure was on the ballot, according to exit polls.
Only 17 states allow citizens, not just lawmakers, to initiate ballot proposals to amend the state constitution. Among those, abortion rights supporters in at least 10 states with abortion bans or tight restrictions — Arizona, Arkansas, Florida, Missouri, Montana, Nebraska, North Dakota, Ohio, Oklahoma and South Dakota — are already discussing strategies and tactics for putting abortion initiatives on the 2024 presidential election ballot.
“They’re starting now, because the process for getting any type of measure on the ballot takes a very long time,” said Kelly Hall, executive director of the Fairness Project, which provides technical assistance on state ballot initiatives.
Abortion rights are particularly well-suited to the ballot measure process, she said, because it gives voters the power to determine how they’ll be governed when elected leaders are out of sync with public opinion.

Nationwide, 6 in 10 Americans say abortion should be legal in all or most cases, according to a June 2022 poll by the Pew Research Center. (The Pew Charitable Trusts funds the center and Stateline.)
In an October poll, 59.1% of Ohioans said they would support an abortion rights amendment to the state constitution. In July, 57% of Floridians said they disagreed with the U.S. Supreme Court’s decision to strike down Roe v. Wade. And even in bright-red Arkansas, a whopping 79% of participants in a poll released earlier this month said abortion should be legal in at least some circumstances.
In recent elections, progressive ballot measures to expand Medicaid to people with low incomes, legalize marijuana use and boost the minimum wage have been successful in both blue and red states.
“Our experience in using ballot measures in conservative states is that when we’re able to take the partisan labels off of certain issues, we can win even in conservative parts of the country, and that’s what we saw happen this year with abortion and reproductive rights,” Hall said.
Leading up to the midterm elections, Clarke Forsythe, senior counsel at Americans United for Life, which opposes abortion, said he was concerned about abortion-affirming constitutional amendments in California, Michigan and Vermont because he said they would take the issue out of the hands of elected leaders.
Interim access
So far, only abortion rights advocates in Oklahoma and South Dakota have filed constitutional amendment initiatives for the 2024 ballot, according to Ballotpedia, which tracks elections in all 50 states. In addition, advocates in Ohio are publicly discussing a similar measure, according to recent newspaper articles.
But for the roughly 34 million women of reproductive age who live in the 25 states where abortion is now or soon will be banned, waiting more than two years to access the procedure in their home state is not an option.
That’s why national abortion rights advocates are urging states where abortion remains legal to continue to invest in funds to help women with low incomes who would have to travel for the procedure. Advocates are also urging abortion-friendly states to use state revenue to shore up clinics in preparation for an influx of patients.
In the meantime, state and national abortion advocates say they intend to pursue all legal and political strategies to gain access for as many patients as possible. Even so, in states with GOP-dominated legislatures and conservative courts following the midterm elections, prospects for expanding access to the procedure in the next two years are dim.
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