How ballot measures will change abortion access

Abortion rights found support at the ballot box in seven states on Tuesday, with access expanded in already legal states and bans lifted in two others.

But in three contests, support for abortion rights remained insufficient. Proposed legal measures failed in Florida, Nebraska and South Dakota – and a countermeasure restricting abortion won in Nebraska – meaning bans and restrictions remain in effect.

Abortion will be widely legalized again in Arizona and Missouri, and existing protections will be strengthened in at least four other states.

In Florida, more than 57 percent of voters supported a measure to enshrine abortion rights in the state constitution, but it failed because the state requires a supermajority of 60 percent to pass ballot measures. Florida had been a major access point for abortion patients throughout the South before a six-week ban took effect in May.

Nebraska voters faced a duel with abortion ballot measures, and misleading advertising campaigns may have caused confusion. A measure that will amend the state constitution to restrict abortions after the first trimester and enshrine existing law received a majority of votes, while a measure protecting abortion rights narrowly lost with 49 percent.

South Dakota will continue to have one of the strictest bans in the country.

Before the election, 21 states banned abortions or imposed pregnancy restrictions on the procedure. Missouri's right-to-win measure is the first to repeal a total ban – one of the strictest in the country and one of the first enacted after the United States Supreme Court ruled on Roe v. Wade had waived in 2022.

Arizona's 15-week suspension will also expire in the coming weeks.

In Arizona, Missouri and Montana, the winning measures will follow Roe v. Wade established a standard that protected abortion up to “viability” – the point at which a fetus could survive outside the uterus, i.e. until about 24 weeks of pregnancy.

New constitutional amendments will expand abortion protections in Colorado, Maryland and New York, where the procedure was already largely legal. Colorado's measure also repealed a previous law that banned the use of public money to fund abortions.

In Nevada, a successful abortion protection measure must be repassed to the point of viability in the next general election before it can be added to the state constitution.

The 2024 election ended a winning streak for abortion rights advocates. Voters in seven states, including Republicans, had previously supported abortion rights in every election campaign since the Supreme Court overturned Roe in 2022.

Abortion rights advocates warn that the ability to protect those rights through ballot measures could be dwindling. Most remaining states with abortion bans are barring citizen-initiated measures from appearing on the ballot, and their Republican leaders are unlikely to bring the issue to voters.

And while former President Donald J. Trump recently stated that he would leave abortion laws to the states if re-elected, abortion rights organizations are preparing for federal action on abortion under his presidency.

“Donald Trump’s election as president of the United States is a deadly threat to reproductive rights,” said Nancy Northup, president of the Center for Reproductive Rights. “We have many states that protect the right to abortion, and if a federal ban is passed, they lose that ability to protect their residents’ access.”