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The big abortion stakes of the 2023 elections

Voters in Virginia, Ohio, and Kentucky will shape reproductive health care in their states — and provide a preview of 2024.

Young woman in red shirt with the slogan “The post-Roe generation votes”
A Students for Life Action volunteer canvasses a neighborhood in the Republican primary election for the Virginia House of Delegates in June 2023. Abortion is a major issue in Virginia’s state legislative elections this year.
Bastien Inzaurralde/AFP via Getty Images
Rachel M. Cohen is a senior reporter for Vox covering social policy. She focuses on housing, schools, labor, criminal justice, and abortion rights, and has been reporting on these issues for more than a decade.

Few states have major elections today. But in those that do, abortion rights are playing a pivotal role.

The outcome of those contests — an abortion rights ballot measure in Ohio, a competitive gubernatorial election in Kentucky, and a fight over whether Republicans in Virginia will gain full control of state government — will shape reproductive health care in those states. The results also have big ramifications for political strategy and investments into 2024, as leaders wait to see if abortion rights yield the same kinds of electoral wins for Democrats as they did in 2022.

For many on the left, the question of whether abortion rights serve as a winning issue has already been decisively answered. Activists and progressive leaders point to the fact that abortion rights ballot measures won in all six states where they appeared in 2022, including red and purple states that otherwise elected Republican candidates. They point to a slew of special elections in battleground states that Democrats have won over the past 18 months, a closely watched Wisconsin state supreme court election where the pro-choice candidate won, and polls showing voters appear to have grown even more supportive of abortion rights than they were before the Supreme Court overturned Roe v. Wade in June 2022.

Still, anti-abortion groups and some Republican officials continue to argue this electoral confidence in messaging that supports abortion rights is misplaced. After the midterms last year, anti-abortion leaders were quick to point out that Democrats failed to unseat incumbent anti-abortion governors, and that candidates who promised to aggressively restrict abortion access, including Florida Sen. Marco Rubio and Ohio Sen. J.D. Vance, prevailed in their contests, compared to Republican candidates such as Mehmet Oz in Pennsylvania and Adam Laxalt in Nevada who shied more from the topic. More recently, activist groups have argued that Republican presidential candidates must double down on anti-abortion bans, contending that any electoral losses the party has suffered to date have been driven by meek commitment and insufficient spending.

The outcomes this election cycle will play a key role in shaping the narratives and expectations headed into 2024. If abortion rights prove salient once again, advocates will be able to more confidently rebut those who worry the earlier wins were driven primarily by other factors.

If Democrats lose or the Ohio abortion rights ballot measure fails, there will likely be more debate and hand-wringing about what went wrong and what that means for the presidential campaign next fall.

Abortion rights are at the center of the fight for Virginia’s legislature

Virginia is the only Southern state that has not restricted abortion rights since the Supreme Court overruled Roe v. Wade, though not for lack of trying. Republicans currently hold a small majority in the state’s House of Delegates, and Glenn Youngkin, a Republican, controls the governorship. But when Republican lawmakers tried to pass a 15-week ban earlier this year, Democrats, who retain a small majority in the state Senate, blocked it. A revival of that effort is front and center for voters this election, with every seat in both legislative chambers on the ballot.

Republicans, for their part, are trying to market their support for a 15-week ban as a “consensus” position, though a number of polls suggest that may be overstated in a post-Roe world. It’s true that before Roe v. Wade was overturned, national polls showed broad support for restricting abortion after 15 weeks, but since the Dobbs decision, voters have been signaling opposition to bans. One poll released this summer even showed a third of Republican primary voters opposing the 15-week ban idea.

Highlighting these emotional complexities, a Washington Post/Schar School poll from April found a small plurality of Virginia voters said they’d back a 15-week abortion ban with exceptions (49 to 46 percent), but the same poll found only 17 percent of Virginia voters wanted abortion laws to become more restrictive.

Youngkin and anti-abortion groups are betting that if they can win in Virginia by running emphatically on a 15-week ban (they prefer the more euphemistic “15-week limit”), then Republicans nationwide should feel more confident adopting their playbook in 2024. They want to prove they can win not only conservatives in deep red America, but also the same Biden-to-Youngkin voters who helped flip Virginia’s governor’s mansion in 2021. (Some GOP donors also continue to hold out hope that Youngkin might emerge as a plausible alternative to Donald Trump.)

Abortion rights groups, by contrast, are betting that voters will reject what Republicans are selling, and show once and for all there’s no such thing as a “consensus” ban. Abortion was a motivating force in Virginia’s Democratic primaries, and Virginia Democrats are going all in now to frame the election as a referendum on abortion rights, with more than 40 percent of TV ads released this cycle highlighting the issue.

Gubernatorial elections in Kentucky and Mississippi reveal contrasting approaches for Democrats in red states

Democratic Gov. Andy Beshear is running for reelection in Kentucky, and leaning hard on abortion rights in his conservative state. The Republican running in the race, state Attorney General Daniel Cameron, has voiced support for a total abortion ban with no exceptions for rape or incest, and Beshear’s campaign has worked to highlight his opponent’s anti-abortion views. (More recently, Cameron said he would sign an anti-abortion bill that included exceptions, but then clarified he meant only if a court ordered it.)

Part of Beshear’s political calculus to focus on abortion rights is fueled by the victory of a ballot measure last year in his red state where 52 percent of Kentucky voters rejected a proposed change to the state’s constitution that would have stripped rights to abortion. The incumbent governor is also hoping to motivate younger voters and suburban women, and if he pulls off a win, the implications for 2024 will be clear.

In the red state of Mississippi, however, Democratic candidate Brandon Presley is making a different calculation, and hoping to win his uphill gubernatorial contest by emphasizing that he’s “pro-life,” supports the state’s current abortion restrictions, and believes life begins at conception. His opponent, Republican Gov. Tate Reeves, has sought to paint Presley as a puppet for the national Democratic Party, and though Reeves is not very popular himself, he’s still favored to win the election.

All eyes are on Ohio’s big abortion ballot rights measure

The only abortion rights ballot measure for the 2023 cycle is in Ohio, where people will vote on a proposed state constitutional amendment to codify abortion access up to the point of fetal viability, and permit abortions beyond that point if a patient’s doctor deems it necessary to protect their life or health. A win for abortion rights in Ohio could bode well for Democratic Sen. Sherrod Brown, who faces a competitive reelection next year and who hopes he can win over independents and conservatives concerned about reproductive freedom. A win for abortion rights in Ohio would also be promising news for those activists organizing for 2024 abortion rights ballot measures, such as those in Florida and Arizona.

Republicans and local anti-abortion groups tried earlier this year to change state law so that it would be harder for Ohio voters to approve the pro-abortion rights measure in today’s election. But their efforts failed, losing by 14 percentage points in August. While polls have indicated that Ohio voters are broadly supportive of the proposed constitutional amendment, it’s not clear what will happen on Election Day in the increasingly conservative state, and anti-abortion groups are eager to change the narrative that their ideas are political losers. One added wrinkle is that the ballot measure is confusingly named Issue 1, the same name as the measure anti-abortion groups in Ohio backed just a few months ago.

Update, November 7, 11 am: This story, originally published October 22, has been updated to be current with the November elections.