The U.S. Constitution gives the states almost total control over how Americans live and vote. Republicans appear to have grasped the importance of this, but most Democrats have not. Since losing the White House and Congress in 2008, the GOP has focused time, money and talent on gaining control of state governments.

Their efforts have paid off. In the 2010 and 2014 midterm elections, older, white and upper-income voters, including many Tea Party supporters, turned out in force, while Democratic constituencies, including many young and minority voters, stayed home. The result is that Republicans control both the governor’s mansion and legislature in 24 states, 70 of the nation’s 99 state legislative chambers, both chambers in 30 states, plus Nebraska’s single chamber, and 31 governor’s mansions.

Nearly 90 percent of the Republicans in the House of Representatives are on the far right of the conservative spectrum, described by Thomas Mann of the Brookings Institution as “a radical insurgency — ideologically extreme, contemptuous of the inherited policy regime [and] scornful of compromise.”

This is also true of GOP state legislators. Republicans hold super-majorities in many states and have wasted no time in adopting radical elements of the Republican agenda. What they’ve done so far provides a telling picture of what a red America could look like.

North Carolina is a poster child for how far a red state can go. Though its voters are almost evenly divided between the two parties, the Republicans have overwhelming majorities in the state legislative chambers, and the party has dominated the congressional delegation since the 2011 redistricting. Before 2010, the state’s congressional delegation was made up of eight Democrats and five Republicans. In the 2012 North Carolina congressional races, Democrats won more votes than the Republicans — 50 percent to 48.9. Yet gerrymandering gave the GOP nine seats and the Democrats four. Republicans today hold 10 House seats, though they won only 55 percent of the 2014 congressional vote. The current state legislative numbers are similarly disproportionate: 74-45 in the house and 34-16 in the senate.

In 2011, when the Republicans took over in North Carolina, they soon began to implement a conservative agenda. They loosened gun rules, limited citizens’ rights to bring civil lawsuits and cut funds for early-childhood education programs. After a state panel warned of rising sea levels from global warming in 2012, the legislature banned any use of climate-change science in setting coastal policy

In 2013, when the U.S. Supreme Court struck down a key section of the Voting Rights Act in Shelby County v. Holder, state Republicans immediately introduced and passed a massive voter suppression law — it has 20 provisions, 19 of which make it harder to vote. The law has since been challenged, and a trial has just concluded.

In that same session, North Carolina reduced unemployment benefits, cut back government regulations, resumed executions and allowed concealed handguns in bars and restaurants. It also repealed the Racial Justice Act, which allowed convicted killers to be spared the death penalty if they could prove racial bias.

Meanwhile, North Carolina ended its earned-income tax credit, extended tax breaks for wealthy taxpayers and replaced its progressive income tax with a 5.75 percent flat tax. Low-income earners now pay at the same rate as multimillionaires.

The North Carolina GOP has also revised local election rules in some of the state’s few Democratic pockets in ways that could increase GOP power. One measure, for example, banned Greensboro from changing council districts without the permission of the state legislature. All other North Carolina cities and towns don’t need such permission. A federal court struck down the law, ruling it had “no rational basis.”

Local autonomy has been undermined in Pennsylvania as well. More than 100 Pennsylvania cities and towns have adopted their own gun control laws. Some, for example, banned guns from parks and other public areas, or limited gun ownership for people guilty of domestic violence.

These laws could disappear, however. Under state law, any gun-rights group to which a Pennsylvania resident belongs can now challenge the local ordinances. The National Rifle Association has sued many of these cities and small towns. Given budgetary constraints, few of these municipalities dared risk losing such a suit, with potentially millions in legal fees and other possible costs. So some have repealed their laws and ordinances.

The Tennessee legislature has also overridden local gun laws. In April, Tennessee authorized guns in parks, which overrode local bans and drew sharp criticism from the Nashville mayor. April was also the month when the NRA held its annual meeting in Nashville.

Meanwhile, abortion has been another prime target of GOP-controlled state houses. Many legislatures have focused on obstructing a woman’s right to an abortion. Roughly 267 abortion restrictions have been imposed in 31 states since 2011, according to the Guttmacher Institute.

States increasingly require long waiting periods, repeated visits before a procedure and lectures by doctors. Stringent new medical regulations require clinics to be virtual mini-hospitals; many have been forced to close. In some parts of the country, a women’s constitutional right to an abortion has been smothered under these new laws.

But new demands continue to appear. In April, Kansas banned dilation and evacuation, the second-trimester procedure recommended by the World Health Organization as the safest, most effective procedure and used in about 96 percent of the 140,000 annual second-trimester procedures.A Kansas state judge has temporarily blocked the law as probably unconstitutional.

Meanwhile, Oklahoma followed Kansas a few weeks later, and similar bills are pending in Missouri and South Carolina. The Supreme Court had relied on the ready availability of this method when it upheld a ban on a different procedure. Thirteen states have banned all abortions after 20 weeks and allow no exception even when the woman’s health is at risk. The Supreme Court has approved abortions up to 24 weeks and even later for health reasons.

Some states have tried other approaches. Medical abortion methods, like the RU-486 procedure, for example, require two separate pills. Arkansas and Arizona have both decided doctors must tell women that this procedure can be stopped mid-treatment by injecting the progesterone hormone after the first pill. This advice is based on a test involving six patients — and succeeded in only four. According to the American College of Obstetrics and Gynecology, this is “not supported by scientific evidence and not recommended.”

Other new measures involve longer waiting periods. The Supreme Court has allowed a 24-hour wait before an abortion, and about 12 states now require that. But in 2011, South Dakota imposed a 72-hour wait, and now Utah, Missouri, Oklahoma and North Carolina have done the same.

This extended waiting period may well be unconstitutional — the Supreme Court described even a 24-hour delay as “troubling.” In any case, it can impose a heavy burden on women. Because most red states have fewer abortion clinics, longer waits can increase the length and cost of hotel stays and meals, as well as a possible greater loss of wages and more time away from family. These costs can be crippling because 69 percent of the women who seek an abortion are poor.

In Arkansas, Louisiana, Alabama and other red states, GOP governors and legislators are also moving to defund Planned Parenthood. They are citing secret videos shot and edited by a longtime antiabortion rights group that purport to show that the organization sells fetal tissue for profit. This is untrue.

Working people, whether in or out of unions, are also facing tougher times under GOP governments. Two years ago, North Carolina prohibited city and county governments from establishing paid sick leave or living-wage requirements for government contractors. A movement in a half-dozen red states is seeking to repeal longstanding laws requiring contractors to pay the locally prevailing wage on public construction projects.

Wisconsin, which eliminated collective bargaining rights for most public employees a few years ago, and Michigan have both passed right-to-work laws, which allow employees covered by a collective-bargaining unit not to pay union dues. GOP presidential candidate and Ohio Governor John Kasich pushed through legislation to end public-employee bargaining rights in 2011, but a referendum overturned the law.

Since 2010, other red states have cut income taxes for upper-income earners, assuring voters that this would produce prosperity for all. Kansas Governor Sam Brownback’s tax cuts produced a budget shortfall of more than $442 million for the 2015-2016 fiscal year. His promised tens of thousands of new jobs and population increases never materialized.

Rather than repeal some of the tax cuts, however, Brownback and the legislature have increased sales and excise taxes, and cut education funding by $51 million. Though the Kansas Supreme Court has found the state’s current education expenditure constitutionally inadequate,Brownback still wants to cut upper-income taxes in his “march to zero” income taxes.

Louisiana faces much the same problem. The legislature cut taxes for upper-income earners by $700 million and is now facing a $1.6 billion deficit. Despite this, Governor Bobby Jindal, like Brownback, wants to make still more upper-income tax cuts. Wisconsin Governor Scott Walker’s tax-cut prosperity has also never materialized, leaving that state budget with a $541 million hole to make up.

Financing government through sales and excise taxes falls particularly hard on the poor, for such taxes consume a far larger portion of their income. In Kansas, for example, the bottom 20 percent pay an average of 11.17 percent of their income in state and local taxes, while the top 1 percent pay just 3.6 percent. Idaho, Maine and Ohio are also considering sales-tax increases, while Georgia and Mississippi aim to eliminate income taxes entirely and rely only on sales and similar taxes.

Children are often the chief victims of these policies. In Kansas, a mass teacher exodus has left more than 700 teaching jobs unfilled. North Carolina cut 10,000 teachers and teaching assistants in the state’s public schools, and eliminated preschool for 30,000 children.

In addition, state universities have also become a prime target for red-state governors. Former Pennsylvania Governor Tom Corbett cut state university funding by 20 percent. Walker cut Wisconsin’s university system by $250 million, and Brownback cut Kansas universities by $16 million.

So, this is what red America looks like today. Given the many legislative chambers Republicans now control and the top-heavy GOP margins, this is almost certainly not going to change soon. At least not until after the 2020 elections, when a new Census can translate into redistricting across the nation.

Republicans’ current state-level margins are so large, however, that they may survive substantial losses even if the Democrats do well in the 2020 state elections. Should that happen, the GOP could again be able to oversee the 2021 redistricting in the states they control.

Yet demographics in some states are changing. A few — including North Carolina, Wisconsin, Michigan, Florida, Nevada and Virginia — could turn purple or even solidly blue in the 2020 election. But that would require voters who are dismayed at what is happening to begin this process by turning out heavily in the 2018 mid-term elections.

The odds of this happening seem slim. Though there is an awareness of the problem among some in the party and among some wealthy donors, most Democratic politicians and voters seem uninterested in who controls the states. Remarkably, that goes for the national party leaders as well.

Unless this changes radically, what the Republicans have done in the past five years may be just a prelude to what’s ahead.