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While most headlines during the 2026 midterm elections have been focused on Congressional elections, a number of states have healthcare-related measures on the ballot this year.
- Proposition 38: Would issue $8.4 billion in general obligation bonds to fund immunology and immunotherapy research. It would require at least $4.2 billion in bond revenue to be used for research related to cancer, heart disease, and Alzheimer's disease and would authorize the state to enter into an agreement with a nonprofit institute dedicated to researching immunology and immunotherapy within 90 days of the effective date of the proposition. Half of the bond revenue, after administrative costs, would be allocated to the designated institute. The proposition would then allocate the rest of the bond revenue to public and nonprofit universities or a medical research institute through a competitive grant process.
- Proposition 40: Would levy a one-time 5% tax on the accumulated wealth of taxpayers and trusts with covered assets valued over $1 billion, including shares of capital stock, bonds, or other evidences of indebtedness, and any legal or equitable interest, to fund state healthcare programs (Medi-Cal as well as other health coverage programs for low- and moderate-income individuals), food assistance programs, and public education.
- Proposition 44: Would require nonprofit federally qualified health centers to spend at least 90% of their annual total revenue on expenses that advance the health center's mission, defined as the "mission spend ratio," which would be calculated annually by the California Attorney General. The state Department of Public Health would be authorized to levy penalties for not meeting the 90% mission spend ratio, which would be equal to the difference between the 90% requirement and the amount the clinic spent on mission-related expenses in that year.
- Proposition 135: Would prohibits healthcare professionals from performing or providing surgeries to persons under the age of 18 for the purpose of altering biological sex characteristics, defined as "treatment in response to a minor's perception of sex or gender." It would also prohibit the use of state or federal funds, Medicaid reimbursements, or insurance coverage to pay for such procedures.
- HJR 4: Would provide only the Idaho State Legislature with the authority to legalize marijuana, narcotics, or other psychoactive substances and remove the ability for citizens to initiate state statutes that would legalize these substances.
- Proposition 1: Would create a right to reproductive freedom and privacy, establishing a right to make private reproductive healthcare decisions, including abortion up to fetal viability and in medical emergencies. The state would be able to regulate abortion after the point of fetal viability except in cases of medical emergency. The government would not be able to interfere with personal decisions about childbirth care, contraception, fertility treatment, miscarriage care, and prenatal, pregnancy, and postpartum care.
- Question 8: Would repeal laws that allow the sale, regulation, and taxation of recreational marijuana as well as laws permitting the personal cultivation of cannabis in homes, permitting people ages 21 and older to possess up to one ounce of marijuana without penalties and possession of up to two ounces of marijuana with only civil penalties, and making possession of up to two ounces of marijuana a civil offense for people under age 21.
- Amendment 3: Would repeal the constitutional right to reproductive freedom, which was ratified in 2024, and would prohibit abortions except in cases of "medical emergency, fetal anomaly, rape, or incest" and permit abortions in cases of rape or incest only through 12 weeks of gestation. The amendment would also prohibit gender transition surgeries for minors, as well as the prescription or administration of cross-sex hormones or puberty-blocking drugs to minors, with an exception for treatments "unrelated to the purpose of a gender transition."
- Question 6: Would provide a state constitutional right to an abortion, providing for the state to regulate abortion after fetal viability, except where medically indicated to "protect the life or health of the pregnant patient."
- Constitutional Amendment I: Would amend the South Dakota Constitution to make Medicaid expansion contingent on the federal government covering at least 90% of the program's cost. Under Amendment D passed in 2022, Medicaid was expanded to people with incomes below 138% of the poverty level, with 90% of the program's cost covered by federal funding under the Affordable Care Act. If federal funding drops below 90%, the proposed amendment would remove the state's constitutional obligation to provide coverage.
- Question 1: Would amend the Virginia Constitution to establish the right to reproductive freedom, defined as "the right to make and effectuate one's own decisions about all matters related to one's pregnancy," which would not be infringed upon, unless justified by compelling state interest. The state would be permitted to regulate abortion for women in the third trimester of pregnancy but wouldn't be able to prohibit abortions if the fetus/baby is not viable or a physician determines an abortion is necessary to protect the life, mental health, or physical health of the mother. The state would also be prohibited from prosecuting or penalizing a mother or another individual from receiving or aiding in a miscarriage, stillbirth, or an abortion.
- AJR 10: Would prohibit the state or any political subdivision from ordering the closure of or forbidding gatherings in places of worship in response to a state of emergency, including public health emergencies.
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