5 states where the abortion fight is likely to play out next | Health Care News | The Hill

A handful of purple and red states are poised to be the next battlegrounds in the abortion rights fight after advocates won a major victory in Ohio this month. 

Ohioans passed a proposed constitutional amendment earlier this month that enshrines abortion rights protections — seen as a major feat in a state that has trended increasingly red in recent years.  

Abortion rights advocates are now looking to amend state constitutions in states such as Nevada, Arizona and Florida in an effort to establish or strengthen existing abortion protections — an effort that could energize Democrats’ base of voters in a critical presidential election year. 

Here are five states where the abortion fight is likely to play out next:  

Nevada 

Abortion access is protected through the first 24 weeks of pregnancy in the Silver State, with exceptions afterward “if the physician has reasonable cause to believe that an abortion currently is necessary to preserve the life or health of the pregnant woman,” according to Nevada law.  

Nevadans approved a referendum in 1990 that backed the state’s existing abortion protections, with the referendum noting that the state’s laws could only be changed “by a direct vote of the people.”  

But abortion rights advocates are looking to put the issue in front of voters again, this time by enshrining them in the state constitution. The proposed constitutional amendment reads, “Every individual has a fundamental right to reproductive freedom, which entails the right to make and effectuate decisions about all matters relating to pregnancy, including, without limitation, prenatal care, childbirth, postpartum care, birth control, vasectomy, tubal ligation, abortion, abortion care, management of a miscarriage and infertility care.” 

The amendment protects abortion access up until fetal viability, except when a provider believes it’s necessary to protect “the life or physical or mental health” of the patient. It also bans the state from punishing a patient from receiving an abortion or a health care provider or someone who assists that patient in obtaining an abortion. 

June 26 is the deadline for advocates to get the 103,000 signatures from voters needed for it to make the 2024 ballot. The measure will need to be reapproved by voters again in 2026 before it’s implemented.  

Arizona 

A coalition in the Grand Canyon State rolled out a campaign in August to get their own abortion rights measure on the ballot in 2024.  

The proposed constitutional amendment would establish that “every individual has a fundamental right to abortion” and protects abortion access up until fetal viability. The amendment notes that the state can’t bar or interfere with an abortion after fetal viability “that, in the good faith judgement of a treating health care professional, is necessary to protect the life or physical or mental health of the pregnant individual.” 

Similar to the proposed constitutional amendment in Nevada, the Arizona ballot measure would also bar the state from punishing someone in helping a patient receive an abortion. 

In order for the measure to come before voters next November, the group will need to collect 383,923 signatures before July 3, 2024. 

Abortion is currently legal in the state until 15 weeks of pregnancy as the Arizona Supreme Court weighs an 1864 abortion law, which bans nearly all abortions except for cases in which the life of the patient is at risk.  

Doctors could go to jail for between two and five years if they illegally perform an abortion under the 1864 law.  

The proposed constitutional amendments in Nevada and Arizona are particularly noteworthy given those states are key battlegrounds in the presidential race. Abortion ballot measures could help enthuse Democrats’ voting base as the 2024 election increasingly looks like a rematch between President Biden and former President Trump, with recent polling showing Trump performing well against Biden in multiple swing states. 

Florida 

The Sunshine State became a focal point in the abortion rights fight this year after 2024 GOP presidential contender and Florida Gov. Ron DeSantis signed a six-week abortion ban. However, that ban is on hold as the Florida Supreme Court separately weighs a 15-week abortion ban, which is currently where abortion access stands in the state. 

Just weeks after DeSantis signed the six-week abortion ban, abortion rights advocates launched an initiative to place a measure before voters next year seeking to protect abortion access in the state. 

The constitutional amendment, if passed, says that “no law shall prohibit, penalize, delay, or restrict abortion before viability or when necessary to protect the patient’s health, as determined by the patient’s healthcare provider.”  

According to Floridians Protecting Freedom, which is organizing the ballot measure push, they need to submit 891,523 signatures by Feb. 1, 2024. The group noted in mid-October that 402,082 signatures had been verified so far. 

Should they clear that hurdle, it still needs to clear a 60 percent voter threshold once it reaches the ballot. 

But state Attorney General Ashley Moody (R) has appealed to the state Supreme Court to not have the ballot measure come before voters. In one of her briefs, Moody alleged that abortion rights advocates “proposed an amendment to the Florida Constitution using a misleading ballot summary to trick voters into freezing in place a legal framework that conceals the amendment’s potentially sweeping legal effects” and argued it was an “effort to hoodwink the Florida electorate.” 

Missouri 

Two different groups are looking to put the issue of abortion on the ballot next year to combat Missouri’s current law, which bans abortion except in cases of medical emergency. 

In March, Missourians for Constitutional Freedom filed 11 different constitutional amendments, all of which are different in some of the language they use but which all use the phrase “the Government shall not deny or infringe upon a person’s fundamental right to reproductive freedom.” Some of the petitions outline when the General Assembly could regulate abortion access; some explicitly say “after 24 weeks of gestation;” while another says up until “fetal viability.” 

Another group, the Missouri Women and Family Research Fund, has also submitted multiple petitions that would offer different amendments to the state constitution. One version states there should be exceptions for “rape or sexual assault, incest, fatal fetal abnormality, or risk to the health or safety of the female seeking an abortion” before fetal viability, though another version does not stipulate specific limits in a patient’s pregnancy in those exceptions.   

A separate version also notes that “the state shall not deny or interfere with the fundamental right to choose to have an abortion through” 12 weeks of pregnancy.  

Groups have until early May to garner the more than 171,000 signatures needed to get the measure in front of voters.  

A summary from Missouri Secretary of State Jay Ashcroft (R) depicted Missourians for Constitutional Freedom’s initiative as allowing for “dangerous, unregulated, and unrestricted abortions, from conception to live birth, without requiring a medical license or potentially being subject to medical malpractice,” according to The Associated Press

But Ashcroft, who is running for governor next year, suffered several defeats in court, with his summaries being changed by a judge, and the state Supreme Court declined to hear his appeal over the wording, according to St. Louis Public Radio.  

South Dakota 

South Dakota might not be the first state that comes to mind amid the ongoing fight over abortion access, but the group Dakotans for Health is looking to change that in 2024.  

The group is collecting signatures for a proposed constitutional amendment that says, “before the end of the first trimester, the State may not regulate a pregnant woman’s abortion decision and its effectuation.”  

During the second trimester, “the State may regulate the pregnant woman’s abortion decision and its effectuation only in ways that are reasonably related to the physical health of the pregnant woman,” and that “after the end of the second trimester, the State may regulate or prohibit abortion, except when abortion is necessary, in the medical judgment of the woman’s physician, to preserve the life or health of the pregnant woman.” 

Abortion is nearly banned in the state, with only an exception for the life of the mother. The group has until May 7, 2024, to gather 35,017 signatures in order to get the measure before voters.  

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