The choice between President Obama and Mitt Romney isn't the only one voters will be making on Nov. 6.
Dozens of state-wide ballot questions will be posed to voters, and their implications could reverberate across state lines.
Here are a few of the most controversial initiatives voters may see on their ballots on Nov. 6:
One of the most closely watched efforts on the ballot in several states this November relate to gay marriage.
Gay rights advocates see ballot efforts in Maryland, Maine, Washington and Minnesota as crucial to their efforts to expand marriage for gay and lesbian couples.
In the case of Maryland, the marriage initiative on the ballot could be the only successful effort to win the right to marriage in a state by referendum. It is being backed by Maryland Gov. Martin O'Malley, who is widely believed to be a potential presidential contender in 2016.
In Washington State, a legislative bill legalizing gay marriage is being challenged on the ballot. In Maine, a ballot initiative would overturn the state's ban on gay marriage, and Minnesota voters are being asked to vote on a measure that would create a state constitutional amendment banning same sex marriage.
Another hot-button social issue, immigration, is being determined at the ballot boxes in several states this November.
With Congress stalled on comprehensive immigration reform, several states, including Montana and Maryland, are taking matters into their own hands with legislation that addresses their states' immigrant population.
Another Maryland ballot initiative closely tied to the fate of rising Democratic political star O'Malley is a provision modeled after the so-called "DREAM Act" that would give illegal immigrants who were brought to the U.S. as children in-state tuition at state colleges and universities.
In Montana, however, voters will decide on a measure that does the opposite, by requiring proof of citizenship for anyone to receive state benefits.
In several other states, voters will have the option to potentially approve legislation that would legalize marijuana for recreational use.
Amendment 64 in Colorado would legalize marijuana for anyone over 21 years old at certain retail stores. Proponents believe the bill could generate millions in revenue for the state government. However marijuana will still be considered illegal by the federal government.
A similar measure is on the ballot in Washington State to legalize small amounts of marijuana for people over 21. In Oregon, voters will approve or reject a measure that would establish a commission to regulate marijuana cultivation and sale in the state.
While a vast majority of states still legally have a death penalty on the books, several, including Connecticut and Illinois have abolished it in recent years.
Looking to join those states this year is California with a ballot initiative that would end the death penalty. If approved, California would become the 18th state to ban the death penalty.
The California legislation, primarily advocated for by the state's Republicans, would prohibit unions and corporations from collecting money for political contributions from their members or employees by automatic paycheck deductions.
The provision is expected to hit labor unions the hardest because they primarily use paycheck deductions as a means to collect dues and contributions from their members. Corporations, however, use this strategy on a much smaller scale.
Unions have launched an aggressive $60 million effort to defeat the measure, according to the Sacramento Bee.
After Montana tangled with the Supreme Court earlier this year in an effort to preserve a 100 year law in the state that had prohibited corporations from influencing elections in the state until in 2010, the Citizens United vs. Federal Election Commission Supreme Court ruling said that corporations and unions could contribute unlimited amounts to certain campaign committees.
In June, the Supreme Court upheld its Citizens United Decision and reversed the Montana law. But the ballot initiative remains for voters to weigh in this November. If approved, the legislation is unlikely to hold up in Federal Court.
In Massachusetts, the controversial physician-assisted suicide issue is on the ballot and in the news once again. The highly polarizing measure, called the "Act Relative to Death With Dignity," would allow terminally ill patients who are given six months or fewer to live the ability to request lethal drugs.
If approved, Mass. would become the third state—after Washington and Oregon— to approve such a law.