SPOTLIGHT ON ABORTION CARE & REPRODUCTIVE JUSTICE 

Abortion is on the Ballot in 10 States: Get the Facts

Written by Sarah Osborn, AMSA Gender & Sexuality Action Committee, Reproductive Justice Coordinator 

Election day is just a month away – on November 5th, you have the opportunity and the right to make your voice heard and impact the future of our country. Reproductive rights are a major focal point in this election, with 10 states featuring them on the ballot. But what does that really mean? During the past year, citizens and state legislators have proposed amendments to change their state’s constitution or create new laws. When citizens initiate this process, it is known as direct democracy, which gives everyday people the opportunity to affect laws. While the process varies by state, only half of U.S. states allow citizen-initiated ballot initiatives. The problem is, only 16 states allow for direct initiatives to amend the constitution, meaning the proposed initiative will go straight onto the ballot without having to be voted upon by state legislation, providing a direct path for citizens to decide about abortion in their state. In order for a citizen initiated change to end up on the ballot, volunteers and sometimes paid canvassers must go out into the community and collect petition signatures. Each state has a different number of signatures required, some states have special requirements for those signatures and other states have different processes for submitting a ballot initiative. 

Even though those states allow for citizen initiated ballots, some state legislatures are trying to make it more difficult to get initiatives on the ballots or succeeding once on the ballot.  

• In Arizona, Missouri, Nebraska, Nevada, and South Dakota, lawsuits are being filed to attempt to disqualify measures and remove the initiative from the ballot. 
• In Nebraska, a competing and more restrictive initiative made it on the ballot which changes the amounts of votes and criteria needed to pass.
• In Montana, the legislation changed voter eligibility statutes to invalidate signatures.
• In Missouri, legislation is using biased language on the ballot that stated the ballot measure would allow for “dangerous abortions, from conception until live birth”.
• In Arizona, legislation is using biased language on the ballot by referring to fetuses as “unborn children”.

For the other half of states, citizens don’t have the ability to initiate ballot measures and there are currently 15 states with complete abortion bans, or early gestation limits, through which the only avenue of change is legislation. In all states, in order for a legislatively-referred initiative to end up on the ballot, the state legislators must draft the language and introduce it in a manner similar to the bill process. Both chambers of the state’s legislature have to vote and approve the initiative before it is placed on a ballot which then is voted on by the citizens. But, the process to approve a ballot initiative does differ in every state, and some states require it to pass in 2 successive legislation sessions before allowing it on the ballot. In states that only allow legislatively-referred initiatives, it limits the ability of citizens to push for changes they want to see and instead relies heavily on elected officials to drive change.

This year, 10 states will have abortion on the ballot, which has set the record for most in a single year.

The 10 states with ballot initiatives:

• Arizona: Citizen-initiated ballot to amend the state constitution to include the fundamental right to an abortion up to fetal viability, after fetal viability to protect the life/health of the pregnant person, and protect against penalties for obtaining or assisting in obtaining an abortion. 
• Colorado: Citizen-initiated ballot to amend the state constitution to recognize the right to abortion and repeal constitutional amendment 3 which denied health insurance coverage for abortions for state employees and those on medicaid.  
• Florida: Citizen-initiated ballot to amend the state constitution to protect the right to abortion up to fetal viability and after fetal viability to protect the health of the pregnant person. 
• Maryland: Legislative-referred ballot to amend the state constitution to guarantee the right to reproductive freedom which includes abortion. 
• Missouri: Citizen-initiated ballot to amend the state constitution to protect reproductive freedom including the right to abortion up to fetal viability, after fetal viability to protect the life/health of the pregnant person, and to protect against adverse action for miscarriage, stillbirth, or abortion for both the pregnant person and anyone assisting them. 
• Montana: Citizen-initiated ballot to amend the state constitution to protect the right to abortion up to fetal viability, after fetal viability to protect life/health of pregnant person, and protect against any aversion action by the government for any pregnancy outcome. 
• Nebraska: 2 opposing ballots
  • Citizen-initiated ballot to amend the state constitution to protect the right to abortion up to fetal viability and after fetal viability to protect the life/health of the pregnant person.
  • Citizen-initated ballot to amend the state constitution to ban abortion after the first trimester, with exceptions for medical emergencies or pregnancy due to sexual assault or incest.
• Nevada: Citizen-initiated ballot to amend the state constitution to protect the right to abortion up to fetal viability and after fetal viability to protect the life/health of the pregnant person. 
• New York: Legislatively-referred ballot to amend the constitution’s equal right amendment for anti-discrimination protections for reproductive healthcare.
• South Dakota: Citizen-initiated ballot to amend the constitution to protect the right to abortion during the first trimester, and after the first trimester to protect the life/health of the pregnant woman. 

In the end, both legislatively-referred and citizen-initiated ballot initiatives end up on the ballot to give voters the final say on election day. But the challenges in getting these initiatives on the ballot, the ads and false information advertised before election day, coupled with potential misleading summaries on election day, can make the process and voting confusing. This is why it is important to understand each ballot before voting day and what voting yes or no would mean in terms of changing the constitution or implementing a new law. Even though these challenges exist, the purpose of these ballots is to empower you, the voters, the citizens, to make your voices heard and influence the change you want to see. This November will be crucial to reproductive justice, your vote is not just a statement, it is the ability to directly influence the future of reproductive rights in your state. 

To learn more about what’s on each state ballot visit the

AMSA Gender & Sexuality Action Committee

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*Note: an excerpt of this Spotlight is included in AMSA Reproductive Health Project eNews #29:
Abortion is on the Ballot: Get the Facts, Oct 2, 2024
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