COLUMBUS, Ohio (AP) — Abortion access is expected to play a central role in the 2024 elections. The preview comes next week, when Ohio voters decide whether to enshrine reproductive rights in their state Constitution.

The amendment is the only abortion question on any state’s ballot this year, a spotlight that has generated intense attention from national groups and made Ohio a testing ground for fresh campaign messaging — some of it misleading. The amendment has drawn more than $60 million in combined spending so far.

Mini Timmaraju, president and CEO of Reproductive Freedom for All, said Ohio offers a vital proving ground heading into next year’s presidential election, when Democrats hope the abortion issue can energize supporters in contests up and down the ballot. Initiatives seeking to protect access could be on the ballot across the country, including in the presidential swing states of Arizona, Nevada and Pennsylvania.

“When we’re able to see how our messaging impacts independents and Republicans and persuades them that this fundamental freedom is important to protect in Ohio, that’s going to be something that we can implement looking at 2024,” she said.

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The battleground on abortion shifted to the states last summer, when the U.S. Supreme Court overturned its Roe v. Wade decision, erasing federal abortion protections that had been in place for half a century. Since then, voters in six states — California, Kansas, Kentucky, Michigan, Montana and Vermont — have either supported measures protecting abortion rights or rejected efforts aimed at eroding access.

Kelsey Pritchard, state public affairs director for the anti-abortion group SBA Pro-Life America, said the outcomes in 2022 offered lessons that the anti-abortion movement has implemented in Ohio through more coalition-building and stronger messaging.

Abortion opponents, she said, “will apply those weapons and learning in other states going forward.”

Republican Secretary of State Frank LaRose advanced ballot language for the Ohio amendment that its supporters said was misleading, while GOP Attorney General Dave Yost took the unconventional step of producing his own ”legal analysis” of the amendment. Its supporters said those actions by top state officials could cost them votes.

But like the anti-abortion movement itself, Ohio’s Republicans have not been in lockstep on the issue.

The GOP-led Ohio Senate has used its website to spread misleading claims about the amendment even as Gov. Mike DeWine has made the rounds of TV stations pledging that his party will pass a reasonable alternative if voters defeat the measure. For the first time in his 46-year political career, DeWine now says he would support exceptions for rape and incest in any future abortion legislation if the measure fails.

The governor has allied with the Ohio Catholic Conference, which is running a campaign through its churches to defeat the amendment, which is on the ballot as Issue 1. Protect Women Ohio, the campaign against it, also has generated support from some Black faith leaders.

Supporters have answered with an ad featuring the senior minister of First Congregational Church in Columbus, who called abortion a private matter and said “government needs to stay out of family decision-making.”

The Ohio amendment would guarantee an individual’s right “to make and carry out one’s own reproductive decisions.” It expressly permits the state to regulate abortions after fetal viability, as determined by an attending physician, as long as any laws regulating the procedure after that point provide exceptions for the life and health of the woman.

Its supporters include Democrats in the state, the ACLU, Planned Parenthood and a bipartisan coalition of labor, faith and community groups. They portray the measure — one of the most broadly worded so far — as a way to enshrine Roe-era abortion rights in a one-time bellwether state that has turned increasingly Republican and has passed some of the nation’s toughest restrictions on the procedure.

That includes a law currently held up by legal challenges that bans most abortions after fetal cardiac activity is detected, before many women know they’re pregnant. That law makes no exceptions for rape or incest.

“This is the most conservative state to date where we’re pushing for proactive state constitutional amendments,” said Carolyn Ehrlich, senior campaign strategist at the ACLU.

Opponents, including state Republicans, the Center for Christian Virtue and Ohio Right to Life, say the amendment provides too much access to abortion and does so too late into pregnancy. They question whether state lawmakers could pass any abortion restrictions at all that would pass constitutional muster if voters approve the amendment.

“This is more than just a pro-choice or pro-life statement,” said Megan Wold, a former deputy Ohio solicitor general working with Protect Women Ohio. “It is an up or down vote, but it’s an up or down vote on very particular language that’s going to have a real impact on the way that Ohio can regulate abortion in the future.”

Protect Women Ohio’s interest in persuading independent and politically moderate voters is about the math, since public support for some form of abortion rights has remained well over the 50% mark in the U.S. for years. AP VoteCast polling last year found that 59% of Ohio voters say abortion should generally be legal.

Peter Range, executive director for Ohio Right to Life, said strong turnout and enthusiasm at the March for Life held at the Ohio Statehouse last month gave him “great hope” for victory on Tuesday.

He said Issue 1 goes too far in limiting the state “and I think once most Ohioans realize that, they’re going to reject it.”

The Issue 1 campaign, Ohioans United for Reproductive Rights, is working to appeal to voters across party lines with a message focused on bodily autonomy and freedom from government intervention.

Kimberly Inez McGuire, executive director of URGE and a member of the coalition supporting the amendment, said messaging similar to Ohio’s was effective across party lines in deeply Republican Kansas, which surprised the nation when it became the first state to protect the right to an abortion after the Supreme Court overturned Roe.

“I think there’s a very progressive value in being able to maintain our liberty, maintain our freedom, have the government not tell us what to do with our bodies,” she said.

McGuire said supporters of abortion rights also were energized by an August special election in which the GOP-led state Legislature advanced a proposal that would have set a 60% supermajority requirement for passing future constitutional amendments. The measure failed badly, and she said it soured many voters on trusting their elected representatives.

Turnout in the election that concludes Tuesday is expected to be robust, building on the enthusiasm from the summer, organizers say. Local election officials anticipate 40% to 50% of registered voters will participate, according to the Ohio Association of Election Officials. That’s higher than a typical off-year November election and up from the 39% turnout in August.

“Ohio voters really know what’s at stake here, because they’ve seen the incredible lengths that the Ohio government will go to to interfere in people’s lives,” McGuire said. “The August election laid bare the strategy of the anti-abortion movement — which is that they understand that the people oppose abortion bans, and so it is now their strategy to put a stranglehold on democracy to try to thwart democratic efforts to support abortion access.”

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Fernando reported from Chicago.

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