In addition to hundreds of federal, state, and local races, voters in the 2018 midterm elections will be weighing in on 155 state-level ballot measures on key issues ranging from taxes to abortion. The following is a guide to some of the major ballot measures, divided by subject area.


An opposition fund aimed at defeating a healthcare ballot is the most expensive this year, and perhaps even in history. Nearly $111 million has been raised to get voters to sink Proposition 8, a measure that would place spending caps on dialysis treatment in California.

California voters will face other healthcare questions, including whether to use bonds to improve children’s hospitals, and whether to set more guidelines around breaks, mental health coverage, and training for ambulance workers.

Voters in Idaho, Nebraska, and Utah will decide through ballot measures whether to allow more low-income people onto the Medicaid program, a move already advanced by 33 states and the District of Columbia. Voters in a fourth state, Montana, will decide whether to make the expansion permanent through a tax on nicotine products.

In Oklahoma, superstores such as Walmart and Costco are hopeful that residents will vote to allow them to provide eyecare services, something 47 other states already allow. Georgians will consider whether to expand housing for people with mental illness, Nevadans will consider a tax exemption for medical equipment, and Massachusetts voters will consider whether to limit how many patients nurses can care for at a time.


Alabama and West Virginia ballot measures would amend their state constitutions to say that abortion rights are not protected. Anti-abortion advocates are preparing for a possible overturn of Roe v. Wade, which would turn the legalization of abortion to the states. Alabama’s measure seeks to establish “personhood” rights to fetuses, writing that a “yes” vote would make it state policy to “recognize and support the sanctity of unborn life and the rights of unborn children, including the right to life.” The West Virginia ballot also would prohibit Medicaid from paying for abortions.

A measure in Oregon would block state and municipal employee health plans, as well as Medicaid funds, from paying for abortions. It has exemptions for rape, incest, and ectopic pregnancies, which occur when an egg becomes fertilized outside the uterus.

Most Oregonians support abortion rights, and while residents in Alabama and West Virginia are among the least supportive in the U.S. when it comes to abortion, opponents are outspending supporters on the ballot measures.


Washington state could be the first in the nation to enact a voter-approved carbon tax to combat climate change. The plan would require fossil-fuel companies to pay $15 per ton of carbon dioxide they release into the atmosphere, beginning in 2020. That rate would rise $2 a year until 2035, reaching around $55 per ton. The carbon pricing proposal will appear on the ballot as a fee, not a tax, to make the initiative more appealing to voters, and for technical reasons.

Colorado voters will have a chance to decide whether to block drilling in most of one of America’s largest oil- and gas-producing states. The measure would ban drilling within 2,500 feet of homes, schools, and “vulnerable areas” such as playgrounds.

Californians will vote in November on a ballot proposition that would kill recent hikes to state gas taxes and vehicle fees enacted in 2017 that fund road repairs and mass transit projects. If it passes, the measure would also require voter approval for any future gas tax increases.

Two ballot initiatives funded by liberal activist Tom Steyer’s NextGen America would increase the percentage of renewable electricity mandated in Arizona (Proposition 127) and Nevada (Question 6).


Minimum wage increases are on the ballots of just two states in 2018, Arkansas and Missouri. That’s down from the number in previous years, reflecting the fact that issue has already had success in the states where increases had the strongest political support. Four states hiked wages based on ballot initiatives in 2016, the same number that backed increases in 2014. Most increases in recent times have come through state legislatures.

In Missouri, Proposition B would incrementally raise the state minimum to $12 an hour by 2023, up from its current level of $7.85, only slightly higher than the federal minimum of $7.25.

In Arkansas, Issue 5 would raise the state minimum wage to $11 an hour by 2021, up from the current level of $8.50. A recent ABC News poll found that voters supported the wage hike by a two to one margin.


California is the epicenter of several tax fights at the ballot this November. The aforementioned gas tax cut is a major one, though so far it’s proving to be a less popular issue than state Republicans hoped.

Proposition 2 would take $140 million per year currently aimed at mental health, raised by California’s Millionaire’s Tax, and redirect it toward backing a $2 billion bond issuance for homelessness prevention and housing.

San Francisco Proposition C has kicked up the debate over the city’s relation to tech and current problems with housing and homelessness. If San Francisco voters pass the proposition, it would create a tax on the revenues of companies with more than $50 million in sales in the city; rates would vary depending on industry. If passed it would also raise the alternative business payroll tax to slightly more than double its current rate, from 1.4 percent to 2.9 percent. The San Francisco Controller’s Office says the new taxes could raise between $250 million and $300 million per year.

Florida voters will determine whether the legislature needs a super majority of two-thirds in each chamber, instead of a simple majority, to approve new tax hikes.

In North Carolina, an income tax amendment on the ballot would lower the cap for the maximum rate at which the state can set its individual income tax; that cap is currently at 10 percent, while the amendment would lower the amount to 7 percent. North Carolina’s current state income tax is a hair under five and a half percent.

Items from bans on taxes for soda (Oregon and Washington state) and feminine hygiene products (Nevada) will also be on ballots this election day.


Michigan will be the first state in the Midwest to legalize recreational marijuana if voters approve Proposal 1, potentially giving activists a regional foothold in their national campaign to regulate the drug like alcohol. Nine states — all in the West or New England — already allow adults 21 and older to possess recreational pot, in addition to the nation’s capital and one U.S. territory. This measure would allow adults to possess 2.5 ounces, or more if they grow it at home.

Federal law still deems pot possession a crime, but national polls find support for legalization as high as 66 percent, and President Trump has expressed support for state autonomy.

North Dakota’s Measure 3 surprised many national marijuana reform advocates, who weren’t involved in drafting it. The measure is written expansively, without limits on personal possession or the number of plants that could be grown at home. There’s not much polling, but similar free-wheeling proposals have been defeated in other states.

Medical marijuana activists in Missouri submitted three separate ballot initiatives, confusing voters and creating a possible court battle after the election. Amendment 2, Amendment 3, and Proposition C differ in proposed tax rates, program management, and proceed distribution. One measure puts the Missouri Department of Health and Senior Services in charge. Another designates the Missouri Division of Liquor Control. The third authorizes physician and attorney Brad Bradshaw to select a medical oversight board. The measures differ on whether taxes should finance cancer and disease research, or veteran care, education, and drug treatment — or simply fund state and local governments.

Utah voters also are considering a medical marijuana initiative. The measure is opposed by the locally influential Church of Jesus Christ of Latter-day Saints, and Republican Gov. Gary Herbert says he will call a special legislative session after the election to pass a church-endorsed plan to legalize medical pot, regardless of the vote.


Colorado’s two ballot initiatives propose changes to the state constitution that would give independent commissions made of 12 citizens each the authority to draw congressional and legislative districts. The commissions would each be comprised of four Republicans, four Democrats, and four unaffiliated voters.

Michigan’s proposed constitutional amendment would create a 13-member commission of voters that draws congressional and legislative voting boundaries every 10 years. The commission would be comprised of registered voters randomly picked by Michigan’s secretary of state. Four of the members would be affiliated with the Republican Party, four would be affiliated with the Democratic Party, and five would not be affiliated with either of the major political parties.

Missouri’s ballot measure amends the Missouri Constitution to create the position of a “non-partisan state demographer” tasked with drawing legislative maps that are then presented to state House and Senate apportionment commissions. The proposal further requires the state demographer to conduct a statistical test to ensure voting maps are drawn to achieve partisan fairness and competitiveness.

Utah’s ballot measure would create a seven-member commission tasked with drawing congressional and legislative maps, which would then be recommended to the state legislature. One member of the commission would be appointed by the governor and the remaining six would be appointed by the Republican and Democratic leaders of the state legislature.

In addition to redistricting, Arkansas and North Carolina will have voter ID ballot measures; Floridians will vote on restoring voting rights to felons; there will also be several different measures regarding campaign finance and ethics.