You’ve likely heard about 2018’s “pink wave,” — the record number of women running for office in this year’s midterms. And while having female candidates on the ballots is important for representation and equality, it’s just as important to be educated about the issues impacting women’s health that we, all across the nation, will be voting on this November 6.

There are 435 U.S. House of Representative seats to fill, and roughly one third of the senatorial seats are up for grabs. So, as you prepare to fill out your ballot, or head to the polls, let’s talk about a few of the midterm issues that will directly impact women’s health.

The tampon tax
The U.S. government classifies many items — bandaids and condoms, to name just two — as medical supplies. But tampons and pads? Not so much. Back in July, the House passed a bill which would allow menstrual products to be paid for with untaxed earnings, via FSA or HSA accounts, but the bill has not yet gone to the Senate. States, are taking the question into their own hands — only 10 states are currently without a tampon tax. In Nevada, Question 2 on the midterm ballot will ask voters to decide if feminine hygiene products should be subject to state and local sales tax. A yes vote will support the effort to make feminine hygiene products tax exempt, while a no vote will keep things as they are.

In three states, abortion amendments are on the ballot
Alabama, Oregon, and West Virginia will all be voting on abortion measures in this year’s midterms. The Alabama State Abortion Policy Amendment, Amendment 2 puts forth the legality of abortion. A yes vote, supports an amendment to “recognize and support the sanctity of unborn life and the rights of unborn children, including the right to life.” A no vote, opposes that position. In West Virginia, Amendment 1, No Right to Abortion in Constitution Measure is on the ballot — a yes vote supports the idea that “nothing in this Constitution secures or protects a right to abortion or requires the funding of abortion.” Lastly in Oregon, voters will decide on Oregon Measure 106, Ban Public Funds for Abortions Initiative. The measure would prohibit public funds from being used for abortions unless “medically necessary” according to a doctor.

A debrief on Roe v. Wade
There are currently 13 abortion cases only one step away from the Supreme Court. So, how does this relate to the midterms? If the Supreme Court were to overturn Roe, the state legislatures will be critical in determining abortion access on the state level. For that reason, it’s important to vote for state legislatures, generally, whose abortion positions you believe in; it’s likely that their position will directly impact your state in the upcoming years.  

Let’s quickly talk Medicaid
Idaho, Utah, Nebraska, and Montana will all be voting on issues directly related to the expansion of Medicaid (aka the nation’s health coverage program for low-income individuals). In 2010, President Obama expanded Medicaid via the Affordable Care Act but in 2012, the Supreme Court permitted states to opt out of that expansion which Nebraska, Utah, Idaho (amongst others) all did. Montana, on the other hand, did not opt out and this time around is voting to expand Medicaid even further. With respect to what Medicaid expansion means for women: Medicaid makes birth control, family planning, STI screening, and gynecological exams (in addition many other procedures) available to those who may not be otherwise able to afford them. If you are voting in Idaho, Utah, Nebraska, or Montana, educate yourself about the propositions on your ballot as they directly relate to Medicaid, and thus women’s health.

Gender identity  
In Massachusetts, voters will be asked to weigh in on transgender rights, and whether or not trans individuals should be protected by anti-discrimination laws in public spaces — like hotels, stores, restaurants, and hospitals. If trans rights are rescinded, this will have a huge impact on the everyday health of all trans people — including trans women.

Above all, the most important thing you can do is make sure you’re registered to vote, find your polling station (or early voting options), and cast you ballot. Every vote matters.

Elena Sheppard is a writer and editor in Brooklyn, NY. Currently getting her MFA in non-fiction writing at Columbia University, her work has appeared in the New York Times, Vogue, and Elle, among others. Follow her work on Instagram or Twitter @eleshepp.