Abortion access, public opinion, direct democracy, and state political institutions in the United States

O'Mahen P. Abortion access, public opinion, direct democracy, and state political institutions in the United States. World medical & health policy. 2024 Jun 10; https://doi.org/10.1002/wmh3.622.

Although numerous states have enacted policies banning or limiting abortion since the Dobbs decision in 2022, public opinion in most states remains solidly in favor of abortion access. However, whether public opinion is reflected in the public policy of individual states depends on how political institutions mediate between opinion and policy. Activists on both sides of the abortion issue, therefore, have attempted to locate policymaking regarding abortion access in state institutional systems most congenial to their desired outcomes. In states with direct democracy, even where legislatures and governorships are dominated by conservative Republicans, activists have been successful in harnessing public opinion to protect abortion rights by winning public referenda. In response, Republicans have attempted to curtail the power of these referenda, shifting power back to legislatures more likely to be held by actors opposed to abortion rights. This venue shopping for policymaking advantage ultimately raises vital, difficult, and often uncomfortable questions about how political institutions and citizens negotiate the boundaries of democratic legitimacy in policymaking.