What voters had to say about abortion rights in 2024

Coloradans for Protecting Reproductive Freedom campaign held an event at the Colorado State Capitol to starts the group's campaign to get a proposed abortion measure on the November ballot in Denver on Jan. 22, 2024.

Coloradans for Protecting Reproductive Freedom campaign held an event at the Colorado State Capitol to starts the group's campaign to get a proposed abortion measure on the November ballot in Denver on Jan. 22, 2024. RJ Sangosti/MediaNews Group/The Denver Post via Getty Images

 

Connecting state and local government leaders

The majority of ballot measures to protect abortion rights passed, but concerns about women’s health outcomes remain.

On Tuesday evening, voters in 10 states cast their ballots to decide on the fate of abortion rights. In three of those states, voters rejected a constitutional right to abortion.

But residents in seven states — Arizona, Colorado, Maryland, Missouri, Montana, Nevada and New York — approved ballot measures to establish or protect abortion rights.

Missouri and Montana have been reliably red states for decades, voting for Republican presidential candidates since 2000. And many eyes were on Arizona and Nevada as swing states in this election. Former President Donald Trump has won or leads the presidential race in those four states at the time of publication.

Trump, who was reelected to the White House, has generally expressed anti-abortion sentiments. But in October, he announced that he would not support a federal abortion ban under any circumstances.

In Nebraska, the first state to have opposing abortion-related measures on the ballot, residents upheld the state’s current ban on abortions after 12 weeks of pregnancy. Ballot measures to establish state constitutional rights to abortion were also rejected in South Dakota and Florida. In the latter state, 57% of voters approved Amendment 4 to protect rights to abortion access, but the measure needed 60% to pass.

Florida became the first state with a ballot measure enshrining abortion protections to be rejected by voters since 2022, when the federal constitutional right to abortion was overturned. Experts noted that it required the highest threshold of votes for approval.

“There’s been tremendous organizing work in [Florida],” said Candace Gibson, director of state policy at the Guttmacher Institute. For instance, the organization sponsoring the initiative, Floridians Protecting Freedom, has reported more than $118 million in campaign contributions. Committees in opposition to Amendment 4 reported more than $12 million.

“But what troubles me is this trend we are seeing from the opposition” of abortion ballot measures, Gibson said, “where they are using legal maneuvers to really tamp down on the public’s engagement on this issue.”  

In September, state police in Florida questioned residents at their home about signing a petition in favor of Amendment 4, a move that critics say was aimed at intimidating supporters of the ballot measure. Florida Gov. Ron DeSantis, a Republican, has said that the state police were investigating claims that some of the signatures in favor of the ballot measure were fraudulent.

“We have, in the Department of State, an office devoted to policing election crimes. They have uncovered prima facie evidence of invalid petitions and fraudulent petitions, and they’re referring it over to law enforcement,” Gov. DeSantis said during a September news conference. “People will be held accountable.”

Gibson also pointed to Arkansas, where opponents of a citizen-initiated ballot measure to establish a state constitutional right to abortion access were able to block the initiative from appearing on the 2024 ballot. In August, the state Supreme Court ruled in favor of Arkansas Attorney General Tim Griffin, who claimed that backers of the ballot initiative failed to properly submit paperwork for the ballot measure.

At the local level, voters in Amarillo, Texas, and San Francisco shaped abortion policies in their jurisdictions. A ballot measure to designate Amarillo as a “sanctuary city for the unborn” was rejected by 59% of voters.

If passed, the ballot measure would have made abortion illegal in Amarillo with few exceptions, prohibit city residents from receiving abortions in other jurisdictions or transporting people outside of the city to receive an abortion, and allow people to bring civil actions against those in violation of the law.

In San Francisco, 82% of voters approved Proposition O, which prohibits the city from investigating or prosecuting a person for accessing reproductive health care and requires the public health department to maintain a list of pregnancy services centers that offer abortions or emergency contraception, among other policies.

Given the public’s overwhelming support for abortion access and protections, Gibson said state and local policymakers should consider how to expand access to the full range of sexual and reproductive health care, including abortion care.

“There is so much more conversation about the connections between maternal health and abortion care and access,” she said. “States with abortion bans are also states with maternity care deserts, with higher rates of maternal and infant mortality rates, and provider shortages.”

According to the National Institutes of Health, maternal death rates in states with restrictions on abortion were 62% higher than in states with increased access to the procedure.

“I think we’re going to see those inequities play out,” Gibson said, “if we continue on this track [of] restricting and banning abortion care.”

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