A political battle over abortion rights is giving Floridians the opportunity to vote on one of the nation’s most divisive issues, spurring unprecedented opposition by Gov. Ron DeSantis, a spate of lawsuits and tens of millions of dollars in advertising in the runup to next week’s election.

The Floridians Protecting Freedom political committee launched a drive to pass what appears as Amendment 4 on the ballot after DeSantis and the Republican-controlled Legislature last year approved a law to largely prevent abortions after six weeks of pregnancy. The law took effect May 1 after a Florida Supreme Court ruling.

The proposed constitutional amendment, in part, says no “law shall prohibit, penalize, delay, or restrict abortion before viability or when necessary to protect the patient’s health, as determined by the patient’s healthcare provider.”

Floridians Protecting Freedom, which has raised more than $100 million for the initiative, and other amendment supporters argue that the six-week law prevents many women from obtaining abortions and threatens the health of women who have pregnancy complications.

But DeSantis has harnessed the full power of his administration to attack Amendment 4, taking a number of steps aimed at dooming the measure.

Joining anti-abortion health-care professionals and religious leaders, DeSantis last week crisscrossed the state in his official capacity as governor to condemn the proposal. The governor’s chief of staff, James Uthmeier, is chairman of two political committees that have raised millions of dollars to oppose Amendment 4 and a separate ballot measure, Amendment 3, which is aimed at allowing recreational use of marijuana.

“This is a very intentionally deceptive and vague amendment that is written to basically deceive as many voters as possible so they can somehow get this thing across the finish line,” DeSantis said of the abortion proposal during a campaign rally-style news conference on Oct. 21.

DeSantis has targeted a pro-Amendment 4 ad asserting that the state’s six-week law wouldn’t allow abortions when the life of the pregnant woman is in danger.

The controversial ad, dubbed “Caroline,” tells the story of a woman who was diagnosed with brain cancer when she was 18 weeks pregnant. Doctors told the woman they could not treat her with chemotherapy or radiation while pregnant, so she had an abortion. The ad asserts that she would not be allowed to obtain an abortion under Florida’s current law.

Floridians Protecting Freedom filed a federal lawsuit after the state Department of Health sent threatening letters to TV stations saying that the ad posed a “health nuisance” and instructing them to pull the commercials.

Chief U.S. District Chief Judge Mark Walker this month granted the committee’s request for a temporary restraining order blocking state officials from taking any action against broadcasters airing the ad or against the committee.

While Florida’s six-week law is considered one of the country’s strictest abortion restrictions, it includes exceptions for a pregnant woman’s health and for cases of rape and incest up to 15 weeks of pregnancy.

But supporters of the measure contend that documentation required to satisfy the exceptions is so onerous that many patients can’t meet the requirements. And many physicians fear heavy sanctions — including steep fines and jail time — if they accidentally violate the law, which requires two physicians to “certify in writing that, in reasonable medical judgment,” an abortion after six weeks is necessary. The law also allows an abortion if a physician “certifies in writing” the medical necessity for an emergency abortion to save the pregnant woman’s life and another doctor is unavailable.

The six-week law has created a bureaucratic burden for obstetricians and gynecologists, who are having to consult with lawyers and ethics panels before providing emergency care to pregnant women, according to proponents of the measure.

“Patients are not being provided care until they are on the brink of death, even if we put them at risk of life-threatening infection … even if their ability to have children in the future is in jeopardy,” Tampa obstetrician and gynecologist Samantha Baer told reporters in a press call last week.

Florida was among a number of Republican-led states that enacted strict abortion bans after a 2022 U.S. Supreme Court ruling that overturned the decades-old Roe v. Wade abortion-rights decision.

Abortion has dominated national politics during the past two years; Vice President Kamala Harris has made the issue a major plank in her Democratic campaign for president.

Backers of Florida’s Amendment 4 maintain it is a nonpartisan effort and have enlisted the aid of numerous Republicans to help garner the 60 percent approval required for passage of any constitutional changes in the state.

Democrats — outnumbered by Republicans in both legislative chambers and shut out of every statewide elected position — are rallying around the abortion issue as they try to chip away at the GOP’s hold on Florida.

Defeating the abortion proposal, meanwhile, could burnish DeSantis’ reputation among conservatives nationally and help pave the way for a second White House bid after his 2024 campaign fizzled. DeSantis’ role in kneecapping — a favorite term of the governor — the proposed amendment could be viewed as a major coup in contrast to other GOP-led states where abortion-rights efforts have succeeded.

In addition to the letters threatening broadcasters, the DeSantis administration is paying for public-service announcements urging a “no” vote on the abortion measure and launched a webpage warning against it. It is unclear how much money the state has spent trying to defeat the proposal.

But Barry Richard, a Tallahassee-based attorney who specializes in constitutional law, said the governor’s overtly state-sanctioned opposition to Amendment 4 is breaking new ground. Richard said he was consulted on the drafting of both Amendment 3 and Amendment 4 but is not actively working on either of the proposals.

It is “common and always had been” for governors to take a personal position on proposed constitutional amendments, Richard told The News Service of Florida in an interview.

“I think that’s part of his function, being the governor. People need to know what he thinks of something,” said Richard, who is married to state Rep. Allison Tant, D-Tallahassee. “But that’s a completely different circumstance than overtly using taxpayer money to create a formal campaign for or against an amendment. I think those things are inappropriate. I‘ve never known them to be done before, and I think it’s setting a very bad precedent.”

Opponents of the amendment also have filed lawsuits that rely heavily on a report issued by the Florida Department of State’s Office of Election Crimes and Security. The report made fraud accusations against some workers who collected petition signatures for the abortion initiative and alleged that Floridians Protecting Freedom illegally paid workers based on the number of signatures they collected.

The lawsuits, filed in numerous parts of the state, raise questions about whether the proposed amendment could be invalidated in the future, even if it reaches the 60 percent threshold to pass in the Nov. 5 election..

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