June 6, 2023

Forget waiting for Congress or state legislatures to act. This year’s midterm elections are offering voters an opportunity to shape public policy directly in the form of various state ballot initiatives that deal with major national issues.
The country witnessed the power of those referendums when voters in Kansas, which is typically considered a safe red state, rejected an anti-abortion measure on the ballot by a decisive 59%-41% margin.
As the fall elections approach, voters in 2022 are being asked to weigh-in on how their states should handle ending a pregnancy, the right to contraceptives, legalizing certain narcotics and extending health care coverage. Even slavery is on the ballot.
Stay in the know:Get updates on these top ballot measures in your inbox
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In at least five states, voters will have to grapple with whether to officially abolish slavery, a question that could lead to a national rethinking on U.S. prison policy.
Many of those topics have stalled in Washington, where gridlock has devoured many reform efforts.
But whether through direct ballot initiative grown by grassroots organizations via petition or indirect referendums first raised by a state legislature, these measures could have major ramifications going forward.
Here are the issues on the ballot to watch:
Kansas voters overwhelmingly chose to uphold the right to an abortion in August, which has emboldened progressives hoping the momentum can mobilize their base through similar ballot initiatives elsewhere.
Now at least four other states — California, Michigan, Kentucky and Vermont — will have similar questions for voters to consider.
On Thursday, the Michigan Supreme Court ruled a proposed constitutional amendment on abortion rights must appear on the November ballot. Under the measure Michigan voters will be able to explicitly enshrine a woman’s reproductive rights in the state constitution.
Montana is asking voters to decide rules around a “born-alive” infant from a failed abortion.
Poll: Most Americans want chance to support abortion rights on state ballot
Roe v. Wade: Abortion to remain divisive issue in states, courts
The proposed amendments in California and Vermont, which already have liberal state laws ensuring abortion right, encompass reproductive freedom as a whole including other protections such as guaranteeing access to contraceptives. 
Voters in Kentucky, a more conservative-leaning state, are being asked this November to restrict abortion rights by declaring that the state Constitution doesn’t recognize such access or require taxpayer funding of abortion.
Montana’s referendum deals with whether infants born alive at any stage of development will be considered “legal persons.” If so, the proposal says, they must be provided medical care. Violators face a $50,000 fine and up to 20 years in prison.
Voters in Alabama, Louisiana, Oregon, Tennessee and Vermont will decide whether to abolish slavery as a part of a larger criminal justice reform movement aimed at prison labor.
The 13th Amendment to the Constitution ended slavery and involuntary servitude when it was ratified in 1865. But a loophole allows it as punishment for someone convicted of a crime and roughly 20 states have a similar exception.
Most referendums are asking voters to declare no form of slavery or involuntary servitude be permitted.
Others go further, such as Alabama’s question which seeks to remove “all racist language” from the state constitution. In Oregon, the amendment would add provisions allowing the state courts or parole agency to order alternatives to incarceration for a convicted individual.
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Criminal justice reform advocates say the referendums are more than symbolic, and could spark larger changes for people who are incarcerated, such as paying them higher wages for prison work or ending forced labor altogether.
In 2018, voters in Colorado, Nebraska and Utah overwhelmingly struck down slavery and involuntary servitude through ballot initiatives.
Legislation has been introduced in California, Florida, New Jersey, Ohio and Texas to put similar ballot questions before voters infuture elections.
Multiple states will give voters a direct say over drug policies with ballot questions on decriminalizing marijuana and certain psychedelics.
At least five states — Arkansas, Maryland, Missouri, North Dakota and South Dakota — are looking to legalize marijuana for residents age 21 or older.
But the provisions in some places go further.
In Missouri the proposed amendment would decriminalize marijuana use and also allow people convicted of non-violent cannabis offenses a chance to seek an early release from prison and have their criminal records expunged.
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A legal battle is still ongoing in Oklahoma to determine if voters there will have a chance to tackle the issue with similar reforms this fall.
Colorado has a ballot initiative asking voters whether the state should define certain psychedelic plants and fungi as natural medicine, including mescaline.
Under the amendment, personal use, possession, transportation and growth would be legal for those age 21 or older. The changes would also create a regulatory agency that would oversee licensed healing centers to administer natural medicine services.
Nevada voters will be given a chance to give workers a pay raise this fall when they’re asked to increase the minimum wage to $12 an hour for all employees.
Right now the state’s floor for how much a person is paid sits between $9.50 to $10.50 per hour, depending on whether they have health insurance.
In 2019, the Nevada legislature passed a measure raising the minimum wage by increments without address the health insurance discrepancy. The ballot question will establish a flat rate for all regardless of their insurance status.
More: Nevada’s minimum wage increases but is less of a living wage than a year ago
On Tuesday, Nebraska secretary of state certified a ballot measure that if approved would increase the minimum wage to $15 an hour by 2026.
Illinois voters are being asked to establish a constitutional right to collective bargaining, which would guarantee workers the right to organize a union.
On the opposite end of the political spectrum, Tennessee voters will weigh approving a right-to-work amendment to the state constitution, which would prohibit workplaces from requiring labor union membership as a condition for employment.
One of the major debates about the Affordable Care Act from a decade ago was whether states would accept or reject federal incentives to expand Medicaid eligibility.
As of this year, 38 states and the District of Columbia have done just that with many doing so through ballot initiatives. Voters in Idaho, Nebraska and Utah, for example, did it in 2018. 
Report: 5 million to 14 million Americans could lose Medicaid coverage when COVID-19 pandemic ends
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South Dakota, one of 12 states that has not expanded Medicaid, will have an opportunity thanks to a coalition of health care groups who joined forces this year to push the idea to the ballot box.
Under the amendment, adults 18 to 65 earning incomes below 133% of the federal poverty level would receive Medicaid. That is roughly $18,000 per person or $37,000 for a family of four.
Other health care related questions are sprinkled around the country.
In Oregon, a ballot initiative would ensure every resident “has access to cost-effective, clinically appropriate and affordable health care as a fundamental right.”
California voters will consider banning the sale of flavored tobacco products.
Stay in the know:Get updates on these top ballot measures in your inbox
In 2020, multiple cities and states had ballot questions dealing with establishing policies around the environment.
Heading into the fall elections this year, New York and California have two proposals that voters will be asked to consider. 
New Yorkers are being asked to support the issuance of $4.2 billion in bonds for multiple projects related to the environment, such as flood-risk reduction, coastal shoreline restoration and land conservation.
For California, which has been beset by drought, wildfires, and other climate change woes, the question is whether to levy a new tax for zero-emission vehicles and wildfire prevention programs.
Under the prosed question, a 1.75% hike would be put on those making more than $2 million annually. That would rake in $3.5 to $5 billion, according to state analysts. 
About 45% of that money would go towards rebates for zero-emission vehicle buyers, especially for those in low-income areas. Another 35% of the new revenue is earmarked for building more charging stations. 
The remaining 20% would be for the wildfire prevention and response actions.


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