Issue Brief
With Abortion on the Ballot in November, 16.5 Million Women Could be Impacted

September 2024
Reproductive Rights

By Katherine Gallagher Robbins, Shaina Goodman, and Areeba Haider

More than two years later, the decision to overturn Roe v. Wade continues to significantly harm millions of people across the nation, impeding their access to abortion, disrupting their economic futures, and putting their health and even their lives at risk. The impact of this decision is particularly harmful for women of color, who are less likely to have access to high-quality, culturally competent health care and face greater economic barriers to getting abortion care.

During the same time, support for abortion access has steadily grown, with 70 percent of U.S. adults saying abortion “should be legal in all or most cases.” Indeed, since the Supreme Court’s decision in Dobbs, advocates have fought to put the question of reproductive freedom directly in front of voters in order to give the public the opportunity to enact policies that would reflect this strong support. When placed on the ballot, these initiatives have proven broadly popular. Voters in California, Kansas, Kentucky, Michigan, Ohio and Vermont have decisively supported abortion access, by either voting against initiatives that would claim there is no right to abortion in state constitutions or affirmatively voting to ensure that the right to abortion is enshrined in their state’s constitution.

In the November 2024 election, abortion access will be on the ballot in 10 states across the country. New analysis from the National Partnership shows that more than 16.5 million women of reproductive age – 21.9 percent of all women of reproductive age in the U.S. – could be impacted by changes to reproductive rights laws in their state.

Our analysis shows that women of color are especially likely to live in states where abortion is on the ballot, with 23.2 percent of all women of color of reproductive age living in these 10 states, compared with 20.8 percent of all white, non-Hispanic women. American Indian and Alaska Native (AIAN) women, Latinas and Black women all especially stand to benefit from these ballot initiatives. We find that 29.2 percent of AIAN women of reproductive age live in these 10 states, as do 24.5 percent of Latinas and 23.3 percent of Black women. Veteran women are also especially likely to benefit from these ballot initiatives – 22.8 percent of women veterans of reproductive age live in these 10 states. Abortion is currently banned in five of the 10 states with ballot measures this fall, meaning that 8.2 million women of reproductive age (half of all women in states with abortion ballot measures) would see a significant increase in their rights should these measures pass.

Our analysis finds that of the 16.5 million women for whom abortion is on the ballot in November:

  • 3.9 million are Latinas,
  • 2.4 million are Black women,
  • 1.0 million are Asian American, Native Hawaiian or Pacific Islander women,
  • 127,300 are AIAN women,
  • 607,700 are multiracial women,
  • 8.4 million are white women,
  • 6.6 million are mothers with children at home,
  • 4.0 million are economically insecure,
  • 1.2 million are disabled,
  • 162,400 are veterans.

Though the exact language of ballot measures varies across states, these measures represent necessary actions – grounded in state-specific realities and circumstances – to strengthen the foundation of reproductive rights and access. Also, while direct democracy initiatives like citizen-led ballot constitutional amendments or legislative referendums can be an important political strategy to stave off abortion bans and restrictions in certain states, the process alone is not enough to protect abortion rights and access across the country. Rather, these state measures are a piece of a larger strategy that includes both state and federal protections for reproductive rights and state and federal protections that provide robust access to care.

Eight of these 10 states’ ballot measures are direct citizen initiates, underscoring the importance of this process. But, importantly, thirty-one states and D.C – representing 63 percent of the nation’s voting-eligible population – do not have a direct citizen initiative process at all, meaning that those voters don’t have the ability to put an issue on the ballot regardless of citizen interest. Those states include 60 percent of the states that are currently restrictive of abortion access, denying yet another avenue for voters to influence abortion policies in their state. In the states that do allow for citizen-led initiatives or referendums, processes differ – and often place a large burden of approval on organizers petitioning to have their issues included on the ballot. Research also finds that state lawmakers are increasingly intervening to thwart the will of voters, altering citizen-led initiatives even after they are passed by voters at the polls.

Moreover, structural barriers to voting undermine the ability of people to enact their policy preferences at the ballot box. There is both a centuries-old history of voter suppression targeting voters of color, women and other historically marginalized communities, and also a current-day effort to undermine the vote for those same communities. The Supreme Court gutted key voting provisions in recent years, most notably in their 2013 decision in Shelby v. Holder. That decision meant that jurisdictions with a history of racist voter suppression were no longer required to clear new election rules with the Department of Justice, opening the doors for regions with a history of discrimination to implement new, discriminatory voting laws without oversight. State laws to restrict voting access proliferated in the aftermath; in 2023 alone, state lawmakers considered at least 356 bills that would limit voting rights, and at least 14 states enacted such restrictions, including photo ID requirements, new restrictions on mail-in and absentee ballots, purging voter rolls, and election interference laws that create criminal penalties for election workers.

To the extent that women, women of color, and Black women in particular, turn out to vote at relatively high rates, a wide array of factors complicates the connection between turnout rates and policy outcomes. The same communities – Black women, transgender people, disabled people – who are most likely to face voter restrictions are also most likely to be subjected to the harms of abortion restrictions, limiting their ability to reject those policies. And at the state level, those states ranked as the most difficult to vote in have a greater likelihood of having enacted restrictive abortion laws.

Despite barriers to voting and despite the challenges of citizen-led ballot initiatives, voters in 10 states have a critical opportunity to advance abortion access this November. As long as threats to reproductive health care persist – and until there are robust federal laws guaranteeing reproductive freedom – these ballot measures can strengthen abortion access for millions of women.


Methodological note: This analysis uses KFF’s Ballot Tracker: Status of Abortion-Related State Constitutional Amendment Measures for the 2024 Election to identify states with abortion ballot measures in the November 2024 election. The list of states in this analysis is current as of August 23, 2024. One state, Nebraska, has two ballot measures pending, one protecting and one curtailing abortion rights. The Movement Advancement Project defines direct citizen initiatives as those that “are put onto the ballot without involvement from the state legislature if they meet certain qualifications, usually related to signature gathering and subject matter, as well as various deadlines.”

This analysis uses the 2018-2022 American Community Survey accessed via IPUMS USA, University of Minnesota, www.ipums.org. We use a five-year dataset to have a sufficient sample size to analyze state-level data. While people of many ages can become pregnant, in this analysis we define “reproductive age” as ages 15-49 to align with the Guttmacher Institute, the World Health Organization and others. While people across the income spectrum may have difficulty making ends meet, in this analysis we define “economically insecure” as living in a family with income below 200 percent of the federal poverty line. This analysis defines “mother” as having at least one own child (including step, adopted, or biological) under the age of 18 in the household. Due to data limitations, there are mothers who are not included in this definition, including those who have non-resident or older children or those whose children have passed away. People are identified as having a disability in this analysis if they responded that they have difficulty in one or more of the following realms: vision, hearing, cognitive, ambulatory, self-care and independent living. This is a limited definition of disability that excludes a portion of disabled people. For more information on how disability is measured in the American Community Survey please see How Disability Data are Collected from The American Community Survey. Racial categories in this analysis do not include women who identify as Latina and/or Hispanic, who are analyzed separately.

Not all women of reproductive age have the potential to become pregnant – many of them may not be able to for medical reasons or they may not participate in sexual activities that could result in pregnancy. Additionally, due to data limitations, this analysis does not include people who do not identify as women but may become pregnant, including transgender men and nonbinary people. The 1.6 million transgender people 13 and older and 1.2 million LGBTQ nonbinary people age 18-60 in the U.S. are deeply impacted by Dobbs. Many transgender and nonbinary people can become pregnant and are directly impacted by this ruling. The harms are more severe for transgender and nonbinary people of color, those who are disabled, and others who are members of multiple marginalized communities. The transgender and nonbinary communities are not mutually exclusive.

The authors are grateful to Llenda Jackson-Leslie, Mettabel Law and Kiera Peoples for their contributions.

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