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2026 Health Policy Voters Guide

Breaking Down the Ballot

A plain-language guide to the health-related measures on November 3 ballots, from the Black Women’s Health Imperative.

Find my state’s measuresWhy this guide exists
Black women voters with voting stickers
25 days until
Election Day
Why this guide exists

Education creates power.

Ballot measures let voters change laws directly. This year, dozens of them touch our health: abortion and reproductive care, Medicaid, housing, clean drinking water, school meals, and who gets to vote and how.

But measure language is often pulled straight from legislation — wordy and hard to follow, especially if you’re reading it for the first time in the voting booth. BWHI’s policy team broke down each health-related measure so you can understand it, and decide, before you get there.

This guide is educational and does not endorse a position on any measure.

  1. STEP 1

    Pick your state

    See only the measures you’ll actually vote on.

  2. STEP 2

    Read what YES and NO mean

    Every measure is summarized in plain language, side by side.

  3. STEP 3

    Make your plan

    Note where you’re leaning and take your list to the polls.

“Education creates power, and when Black women are educated about the issues impacting our health, our families, and our communities, we are able to make informed decisions that shape the futures we want to see.”

Joy D. Calloway, MBA, MHSA President & CEO Black Women’s Health Imperative — the first nonprofit created by Black women to protect and advance the health of Black women and girls.
The breakdown

Ballot measures 101

Ballot initiatives are a form of direct democracy: they let everyday people vote directly on changes to laws and policies. Often called ballot measures, they appear as direct questions to voters — and they can cover any topic, including many that affect our health directly or indirectly.

YES

means you approve the measure becoming law.

NO

means you oppose the measure becoming law.

Read it before you go

Measures often use language pulled straight from a bill, so they can be wordy and hard to follow — especially the first time, in the voting booth.

The four common types of ballot measures

01

Citizen-initiated constitutional amendments

Citizens propose amending their state constitution and bring the proposal to voters. Direct initiatives go straight to voters; indirect initiatives go to the state legislature before potentially reaching the ballot.

Who starts it:
Residents
Where:
17 states
02

Citizen-initiated state statutes

Citizen-led measures that create state laws rather than change the constitution. These can also be direct (straight to voters) or indirect (to the legislature first).

Who starts it:
Residents
Where:
21 states + Washington, D.C.
03

Legislatively referred measures

State legislators or local lawmakers place a proposed measure on the ballot for voters to decide.

Who starts it:
Lawmakers
Where:
Every state legislature can refer measures
04

Veto referendums

Citizen-initiated measures that give voters the power to repeal or uphold an existing law.

Who starts it:
Residents
Where:
23 states + Washington, D.C.
Not every state lets residents propose measures, and states that do each have their own process. Once a measure is officially on the ballot, it goes before voters. Source: Ballot Initiative Strategy Center (BISC)
Find your measures

Browse the ballot your way

About these measures: This guide highlights the ballot measures that connect to BWHI’s Five Policy Pillars — the health issues our policy work centers on right now. It isn’t a complete list of everything on your ballot, so check your state election office for your full sample ballot.

Choose your state

Alabama

Our vote is our power.

Share this guide with your sisters, friends and family before November 3.

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