- United States presidential elections are held every four years to elect the president and vice president. The elections are run by state governments, not the federal government. Voters select electors who then vote for the candidates. - Candidates must meet ballot access requirements to be listed. Major party nominees and other candidates who meet signature requirements are listed. Voters can also write in candidates. - If no candidate wins a majority, the House of Representatives chooses the president and the Senate chooses the vice president. Voter turnout has declined in recent decades despite increased registration.