Abortion Rights Are on the Ballot in 4 States in the 2026 Midterms

Abortion is once again on the ballot. While the fate of the U.S. Senate and the U.S. House both hang in the balance, the Trump administration can still wreak havoc on abortion rights with or without congressional approval, including a backdoor ban on medication abortion. That’s why state-level measures on abortion in the 2026 midterms elections will be so consequential in the fight for reproductive rights.

This November, voters will decide the fate of abortion rights in four states. Three of those states — Idaho, Nevada, and Virginia — have initiatives that would protect abortion rights in the state. Missouri has an amendment on the ballot that undoes the results of the referendum two years ago, in which voters approved a measure to enshrine reproductive freedom in the state constitution.

Here’s a closer look at the stakes for abortion rights in each of those four states:

Missouri

If you thought Missouri just did this, you’re not wrong. After Roe v. Wade was struck down in 2022, Missouri became the first state to enact a total abortion ban, without exceptions for rape or incest. But Missourians weren’t okay with that. In the 2024 general election, despite overwhelmingly going for Trump, Missouri voted to enshrine the right to abortion in the state constitution, becoming the first state to overturn an abortion ban by the direct vote of the people. That should have been the end of it — abortion was a protected right that could not be infringed by lawmakers in the state. Abortion providers and advocates began challenging the state’s restrictions in court, including an essential ban on providing medication abortion, and won.

But far right leaders like the Attorney General Catherine Hanaway and the Republicans in the Missouri state legislature have simply refused to accept defeat. Now, they’ve enjoined a near-total abortion ban (this one does contain exceptions for rape and incest, as well as fetal anomalies) with a ban on gender-affirming care for minors. Nevermind that gender-affirming care for minors is already banned in Missouri. This is a nakedly political attempt to use transphobic backlash to undo the will of the people and sneak in a ban on abortion.

If Missouri voters approve Amendment 3, nearly all abortions and gender-affirming care for minors will be banned, and a host of anti-abortion measures will also become law, including a ban on public funding for abortion and TRAP (Targeted Regulation of Abortion Providers) laws that are designed to make it more difficult for reproductive health clinics to operate.

Idaho

Idaho has had a total abortion ban in effect since August of 2022, and it has had devastating consequences for the state. After its draconian abortion ban went into effect, the state lost approximately 35 percent of its practicing obstetricians, and at least three rural hospitals have shuttered their labor and delivery departments as a result. This last left Idahoans with an acute lack of access to reproductive health care, and left the remaining OBGYNs in the state overwhelmed with an increased patient load. The results are catastrophically long wait times — in Boise, it can take up to nine months to secure an appointment for an annual exam.

With Proposition 1 on their midterm ballot, Idaho voters now have a chance to reverse some of that harm. This ballot initiative would establish a fundamental right to reproductive freedom and privacy in the state. If voters approve this initiative, it would give providers and advocates an avenue to challenge the state’s total abortion ban in court and potentially legalize abortion services.

While Proposition 1 is a step in the right direction, it wouldn’t carry the same weight as a constitutional amendment. Instead of codifying abortion as an inherent right in the state’s constitution, Proposition 1 would instead create a “statutory right” to abortion. Statutory rights are easier to change than constitutional rights and remain subordinate to the constitution — they can be challenged in court with a lower threshold than a constitutional amendment. If Proposition 1 passes, it would hopefully ease some of the severe restrictions facing the state, but it would be the beginning of that fight, rather than the culmination of it.

Virginia

Voters in Virginia, meanwhile, have the opportunity to enshrine the right to an abortion in their state’s constitution with Question 1, the Right to Reproductive Freedom Amendment. Unlike Idaho, abortion is currently legal in Virginia up to 26 weeks and 6 days of pregnancy. Virginia and North Carolina remain the only two states with legal abortion past 12 weeks in the Southeast, and Virginia is the only Southeastern state with legal abortion services past the first trimester. As such, Virginia has become a critical hub for abortion seekers — from 2020 to 2025, the number of abortions performed in the state has increased by 114 percent.

If passed, this amendment likely wouldn’t change the current status of abortion access in Virginia. The provision does allow for some restrictions on abortion in the third trimester, though abortion is currently banned in the third trimester now. But it would establish the right to an abortion in the state constitution, which makes it harder to restrict the procedure overall. And it would be an important signal to the region that it’s not just enough for abortion to be legal — it must be constitutionally protected. Abortion is a fundamental right, and by enshrining it in the state constitution, Virginians would show that no matter what the federal government does, this right will remain intact within their state’s borders.

Nevada

Like Virginia, abortion is currently legal in Nevada, but with Question 6, the Right to Abortion Initiative on the 2026 ballot, Nevadans have a chance to enshrine the right to an abortion in the state constitution. This effort, led by Nevadans for Reproductive Freedom, would guarantee the right to an abortion in Nevada until the point of fetal viability, or the point at which the fetus can survive outside the womb, typically considered 24 weeks. Essentially, Question 6 would codify Roe v. Wade in Nevada and make it far more difficult for abortion opponents to ban abortion before the third trimester. It would, however, leave the door open to restrictions on abortion in the third trimester, which are already incredibly rare; only 1 percent of all abortions occur after 21 weeks.

Nevada, like Virginia, has also experienced a surge in abortion seekers since the fall of Roe in 2022. In the first year after Dobbs, Nevada experienced a 33.5 percent increase in the number of abortions. As a neighboring state to Idaho, which currently has a total abortion ban in effect, Nevada has been a mini-haven in the region for abortion seekers. If Question 6 passes, it will further entrench abortion rights in the state.

So much is at stake in this year’s midterm elections. With an entrenched autocrat in the White House, a sycophantic Congress willing to do his bidding, and a Supreme Court willing to rubber stamp some of his most heinous policies, defending the constitution and our fundamental rights has never been more essential. The White House has intentionally delayed attacks on abortion until after the midterm election, assuming that they will be politically unpopular. Voters in these four states will have a rare opportunity to directly vote on the status of bodily autonomy, and the results could affect us all.