Virginia and Nevada voted to protect abortion rights, and Missouri voters rejected a repeal of protections they approved in 2024. In Texas and Georgia, newly elected Democratic governors want to expand Medicaid, but they still need lawmakers’ support. The 2026 midterms gave Democrats control of Congress and opened new possibilities in statehouses. For women, the first changes will depend on where they live and which decisions are already in law.
The November 3 election changed who gets to write the budget, call federal officials to testify and put legislation to a vote. It also changed who will write the first draft of state budgets in Texas, Georgia and Ohio. Those shifts could reach women in different ways. A constitutional amendment can protect a decision about a pregnancy. A state budget can determine whether a woman qualifies for health insurance or finds a child care spot she can afford. Each depends on a different part of government.
Where did voters change abortion rights directly?
Virginia and Nevada voters approved constitutional protections for abortion. Virginia’s amendment establishes a right to reproductive freedom, including abortion before the third trimester and under specified circumstances afterward. Nevada voters approved a constitutional right to abortion until fetal viability, with an exception afterward when necessary to protect the pregnant patient’s life or health. The two amendments use different standards, and both give patients and providers a state constitutional basis to challenge restrictions.
In Missouri, voters rejected a measure that would have repealed the reproductive freedom amendment they approved in 2024. That preserved an existing constitutional protection. In Idaho, voters rejected a proposal that would have established a statutory right to make reproductive health decisions, including abortion until viability. Ballotpedia tracked all four ballot measures.
The next question is what those decisions mean at the clinic door. A constitutional protection gives patients and providers a stronger legal footing. Appointment availability also depends on providers, facilities and the practical cost of reaching them. For someone who has to arrange transportation, miss a shift and find care for a child, those details can determine whether an appointment is within reach.
Could more women qualify for Medicaid?
Texas Gov.-elect Gina Hinojosa, Georgia Gov.-elect Keisha Lance Bottoms and Wisconsin Gov.-elect David Crowley campaigned on expanding Medicaid. Republicans still control at least one legislative chamber in Texas and Georgia. The first test will be whether the governors can get an expansion proposal through their legislatures and secure state funding. For a low-income adult who falls outside her state’s current Medicaid eligibility rules, expansion could mean coverage for routine care as well as emergencies. STAT examined the prospects in all three states.
At the same time, a federal law is moving Medicaid in the other direction for some adults. States generally have until January 1, 2027, to implement a new requirement that certain enrollees document 80 hours per month of qualifying activity or meet another qualifying standard. Federal exemptions include pregnancy, the postpartum period and parents or caregivers of children younger than 14. Federal guidance explains who is affected and who is exempt.
In January, women can watch for two developments. An expansion bill or a line in the state budget will show whether the campaign pledge is moving toward a vote. For people already enrolled, state renewal notices will explain how to document qualifying activity or establish an exemption. Whether an agency can verify an exemption using information it already has can affect whether someone keeps coverage while paperwork is resolved.
Can New Mexico turn free child care into more available places?
In March, outgoing Gov. Michelle Lujan Grisham signed a universal child care law that put New Mexico’s no-cost program on a statutory footing. Gov.-elect Deb Haaland backed universal child care during her campaign. Her administration will inherit the work of funding the program, helping providers expand and recruiting enough workers to serve families who qualify. For a look at how child care costs shape mothers’ employment decisions across the U.S., see our coverage of Reshma Saujani’s documentary No Country for Mothers.
For a parent working early mornings or evenings, the value of the program depends on finding a provider whose hours match her shifts. For providers, adding places takes space and staff. The state’s first budget under Haaland will show how much it can put toward expanding capacity and supporting the workforce, including in communities where families still have few options.
What can Democrats do in Congress while Trump is president?
When the new Congress convenes in January, Democrats can use both chambers to hold hearings, scrutinize how federal agencies administer health programs and negotiate spending. Their Senate majority also gives them control over whether Trump’s nominees, including nominees to the federal courts, advance. Those powers matter for the enforcement of existing law and for the judges who will hear future challenges to it. The Associated Press tracked the change in control of Congress.
A nationwide abortion protection or a broad paid leave law faces a higher bar. Ending a filibuster on most legislation takes 60 Senate votes, and Trump can veto bills that pass both chambers. Overriding a veto requires a two-thirds vote in each chamber. Democrats can bring proposals to a vote and press for provisions in spending negotiations. Enacting a major new federal right would require support beyond their congressional majorities.
How will women know whether the blue wave changed anything?
The record gains for women in governors’ offices will put more women in charge of proposing budgets and directing state agencies. The next measures of change will be specific. In Virginia and Nevada, watch how the new constitutional protections are implemented. In Texas, Georgia and Wisconsin, look for Medicaid expansion in a budget or a bill that can pass. In New Mexico, track whether the child care program adds places in communities where families are still waiting. Those decisions will determine whether an election victory translates into an appointment, an insurance card or a child care spot.