Voters decide state health and social policies in midterms

Voters across more than three dozen states weighed in on 145 ballot measures during the Nov. 3, 2026, midterm elections, addressing policies ranging from reproductive rights to transgender youth care and marijuana laws.

In the area of abortion access, Nevada and Virginia voters approved constitutional amendments intended to protect reproductive rights. Conversely, Missouri voters rejected a legislatively referred measure that would have repealed existing rights and restricted access, while Idaho voters turned down a proposal that sought to create a legal pathway to challenge the state's total abortion ban.

Results regarding transgender-related measures were mixed. Missouri voters rejected a proposed ban on gender-affirming healthcare for minors. Meanwhile, voters in Washington, Arizona, and Nebraska supported measures to restrict transgender youth participation in sports. In Colorado, proposals to limit transgender youth sports and ban gender-affirming surgery for minors were leading as of Nov. 4, 2026.

Alina Salganicoff, director of women's health policy at KFF, noted that each state maintains its own distinct culture regarding these policy decisions. Sarah Kate Ellis, president and CEO of GLAAD, characterized the election results as a victory for accountability, arguing that efforts focused on transgender issues did not resonate as a successful political strategy.

These ballot initiatives were placed before voters as a test of various political priorities. While the election saw shifts in federal and state-level offices, the outcomes of these specific health and social policy measures did not follow a uniform national trend.