Decentralization of Abortion Regulations to the County Level

Health
,
1

Title: The Local Reproductive Autonomy Act (LRAA)

Background:
The debate over abortion rights has long been polarized, especially following the overturning of Roe v. Wade, which returned the authority to regulate abortion to the states. However, this shift has led to significant disparities in access to reproductive healthcare, depending on state laws. The LRAA proposes a novel approach by decentralizing abortion regulations to the county level, aiming to balance local governance with individual rights while respecting the broader framework of state sovereignty.

Objectives:

  • To ensure that access to abortion remains viable at a local level within states, thereby preventing total bans within states.
  • To respect state laws while providing counties with the autonomy to reflect their community’s values on reproductive rights.
  • To establish a uniform national policy regarding late-term abortions, ensuring consistency in consideration of fetal viability.

Policy Details:

  1. County-Level Regulation:

    • Each county within a state is empowered to set its own regulations on abortion, up to the point of fetal viability, as determined by the latest medical standards, typically around 24 weeks gestation.
    • Counties can choose to be more permissive than their state laws but cannot exceed the restrictions set at the state level if more restrictive than this policy.

  2. Post-Viability Abortion Restrictions:

    • Abortions after the point of viability are prohibited, except in cases where:
      • The life or health of the mother is at risk.
      • The fetus has lethal or severe congenital anomalies incompatible with life post-birth.
    • These exceptions require certification by at least two medical professionals, one of whom must be a specialist in fetal medicine or obstetrics.

  3. State Oversight and Compliance:

    • States must establish a framework for counties to enact and enforce their regulations, ensuring they meet minimum federal health and safety standards for medical procedures.
    • States retain the right to review county regulations for compliance with state constitutional rights and general welfare provisions.

  4. Funding and Accessibility:

    • Federal funding through block grants or specific reproductive health grants could be allocated to states to improve access in underserved areas, ensuring that economic status does not hinder access to safe abortion services.
    • States and counties must ensure that there are adequate healthcare facilities capable of providing abortion services, with considerations for rural areas potentially needing mobile clinics or telemedicine for early-term abortions.

  5. Education and Information:

    • A national campaign to educate on reproductive health rights, focusing on the new decentralized approach, its implications, and the legal framework surrounding abortion post-viability.

  6. Legal Safeguards:

    • Incorporate legal protections to prevent harassment of healthcare providers and patients accessing abortion services.
    • Establish clear judicial review processes for counties and individuals challenging state or county decisions related to abortion regulations.

Implementation Strategy:

  • Legislative Action: This policy would require federal legislation to empower states to allow counties to regulate abortion within the outlined framework.
  • State Response: States would need to amend their state laws to comply with or facilitate this new structure.
  • Public Input: Local referendums or town hall meetings could be utilized by counties to gauge public sentiment before setting their policies.

Challenges and Considerations:

  • Legal Challenges: This policy could face constitutional challenges on the grounds of state sovereignty or individual rights.
  • Healthcare Disparities: Ensuring equitable access across different counties, particularly in rural or low-income areas, remains a significant challenge.
  • Political Resistance: Both pro-choice and pro-life advocates might oppose this policy for not going far enough in either direction.

Conclusion:
The LRAA attempts to navigate the complex landscape of abortion rights by localizing decision-making while imposing a nationally consistent late-term abortion policy. This approach aims to increase accessibility while respecting diverse community values and state rights, potentially fostering a new dialogue on how reproductive rights can coexist with local governance.

2 Likes
2

What existing examples of the Federal Government legally telling the states that they have to give deference to their individual counties can you cite?

2 Likes
3

There are no incidences where this has occurred.

However, federal funding via block grants could be withheld until state legislatures defer the vote to the county level.

I don’t see how furthering a representative democracy into a more concentrated population at the county level can be argued against.

Clearly abortion is a deeply nuanced issue that has been ripping our country apart for decades.

Returning Roe to the states was wise, it’s where it should exist. However, there are real consequences for not allowing access to abortion procedures/medications at the state level.

I know the instances of occurrence are rare and statistically unlikely.

I see both sides as losing out in this equation, and equal balance of perceived loss. In fact, creating competition amongst states ratifying Roe may lead to an unintended consequence where the entire country codifies Roe in their state constitutions to attract citizens.

4

I am fully aware how controversial an issue abortion is.

However, abortion is not the only controversial issue facing the United States.

Are there any other issues where you think that the states should be denied the ability to have a say on an issue and instead have it directed to individual counties?

Why stop at county level? Why not direct it to be decided on a city by city level?

I happen to live in a city that is divided across two counties. Following the proposal you’ve written, if one of the counties made one decision on abortion and the other county decided something else, you could have a scenario where you could easily have rules surrounding abortion change simply by crossing the street.

Except this proposal says that you don’t want abortion decided as a state level, you want it decided a county level.

“Both sides loosing” sounds like a terrible way of approaching politics. People don’t like losing, they especially don’t like when their preferred policies lose.

If you want this to have any validity as an idea you’re going to have to start with figuring out how you can argue for both sides somehow winning rather than both sides somehow losing.

If all sides lose, then all sides are going to strongly oppose the idea.

6

I’m sorry to give you a thumbs down, because I can tell you put a lot of thought into this, and it’s nicely written, but I strongly oppose the premise and intentions of your bill.

Not only is abortion horrible, but localizing it at a county level would make any restrictions in the next county useless.

Thousands of fully formed, second trimester babies are getting dismembered, ALIVE and AWAKE to feel the whole thing, because the majority of second trimester abortions are given WITHOUT the fetal digoxin shot/fetal anesthesia/fetal pain relief. Babies aborted between 15-24 weeks are often born alive, only to die gasping for breath within minutes or hours. And many of these Democrat-run county leaders are too ignorant, and too uncaring, to deserve our trust to manage this issue.

Additionally, unfortunately, Trump has repeatedly said that he will not sign ANY abortion ban, so I presume that means even a ban at 24 weeks that you suggested.

Besides that, post-viability abortion is NEVER needed to protect a mother’s life or health (in which case a live delivery can be induced without killing the child). Finally, abortionists have regularly abused “viability” definitions and vague “health” exceptions. Those things have enabled them make up their own definition of viability, at any point of the pregnancy, and to abort healthy babies, in healthy pregnancies, well beyond the viability point, because of “mental” or “financial” health reasons.

I suggest a different approach, that will address top concerns about abortion and pro-life laws, will protect maternal & fetal healthcare and END the polarization/misinformation behind these issues. Can you please consider it? Thank you.

RIGHT TO MATERNAL/FETAL HEALTHCARE & EDUCATION to stabilize the abortion issue

2 Likes
7

It’s okay. Thank you for your participation! This is how we grow together.

I very much appreciate your passion for this topic. It’s something very close to home for me.

I lost a child due to an unwanted abortion. It was devastating. I also experienced an atopic pregnancy and was forced to abort the child. I will never stop grieving the loss of my children. God says “He knew us before we were born.” And I too, knew my children before they were born.

Your policy proposal is very well thought out and seems to convey a detailed nuance that I very much appreciate.

I completely agree that use of abortion for birth control (which is most predominant) is abhorrent.

I believe a greater clarity for restrictions are needed. We cannot have Laissez-faire abortion regulations like what currently exists in many states (Minnesota being one of the most egregious).

I’ve taken the liberty to summarize your very detailed post… Would you say this is an accurate summation?

Summary of the Proposed Abortion Policy Package:

Summary

Overview:
This comprehensive policy proposal aims to address the multifaceted issues surrounding abortion by creating a balanced federal framework that respects states’ rights while ensuring women’s health, rights, and exceptions under specific conditions. Here’s a breakdown:

  • Federal Exception Law for Abortion:

    • Exceptions: For life-threatening conditions, nonviable pregnancies, severe fetal abnormalities, very young mothers (under 14), and cases of rape or incest up to 15 weeks with documentation.
    • Clarity and Accountability: Clear definitions to avoid medical delays in life-saving procedures, with state medical boards and attorney generals providing guidelines and legal assessments.

  • Healthcare Access and Accountability:

    • Funding and Coverage: Ensures Medicaid and insurance cover medically necessary abortions under the federal exceptions, with strict documentation and fraud penalties.
    • Provider Accountability: Fines for medical providers who delay or refuse necessary care; requirements for informed consent.

  • Limiting Excessive State Penalties:

    • Criminalization Limits: Bans on criminal penalties for women seeking abortions and limits on punitive measures against abortion providers to prevent excessive legal repercussions.

  • Fetal Healthcare Rights:

    • Abortion Procedures: Requirements for fetal pain relief in later-term abortions, restrictions on certain late-term abortion techniques, and ensuring care for babies born alive after abortion attempts.

  • Support for Mothers and Children with Disabilities:

    • Medical and Adoption Support: Funding for treatments for conditions like Trisomy 18, adoption support for disabled infants, and policies to protect disabled individuals from abuse.

  • Parental Support and Education:

    • Education Programs: High schools to provide comprehensive education on reproductive health, parenting, and child development.
    • Parental Coaching: Postpartum support with in-home coaching for new parents to assist with parenting skills and child development awareness.

Summary Conclusion:

This policy proposal aims to navigate the contentious landscape of abortion by offering a balanced approach that respects states’ rights while ensuring protections for maternal health and fetal rights. It seeks to clarify legal ambiguities around abortion, reduce the misrepresentation of abortion laws, and provide support mechanisms for mothers and their potential children, especially in cases involving disabilities. By addressing the multifaceted dimensions of abortion—from legal exceptions to educational reforms—it attempts to mitigate the political divisiveness of the issue while enhancing healthcare access and quality. This framework is designed not only to legislate but also to inform, support, and potentially shift public perception towards a more informed and compassionate discourse on reproductive rights.

8

And forgive me, I’m a man, so I am out of my depth when it comes to women’s health, admittedly.

However, my aunt was forced to abort her child at 26 weeks when an ultrasound found that it’s brain, liver, and heart were growing outside of it’s body.

This was in the 90’s so it seemed that screening was postponed.

During our pregnancies we were ultrasounded and screened very early on in the pregnancy.

Is that completely true that there is NEVER a medical necessary abortion after 24 weeks?

10

Very interesting.

Thank you for the dialogue.

I wasn’t recommending replacing your post.

1 Like
11

My proposal supports exceptions in cases of nonviable/extreme fetal abnormalities, even post 24 weeks.

However, abortion after viability (killing a viable child) is NEVER medically necessary to save the mother’s life. If the mother’s life is in danger, IMMEDIATE delivery is medically recommended. If necessary, a c section takes 30 minutes to complete.

Guess how long a late term abortion would take. At 26 weeks, it would take at least THREE DAYS to prepare and complete.

Which one seems more effective to address the mother’s pregnancy-related emergency?

Thanks for nicely summarizing my proposal. I choose the leave the current details in, because they are all crucial, and I don’t want to let anyone to miss them. These details are more important to me than votes.

BTW, since Trump said he won’t sign an abortion ban, my proposal does NOT prohibit terminating the pregnancy/inducing delivery at any point of the pregnancy. However, it does restrict the use of feticide against viable babies determined likely to survive.

1 Like
12

You clearly have a very good grasp on the situation.

It does seem we have to offer a concession proposal (concede on killing children? I know.) as we march towards an America that has no desire to continue this practice.

Infanticide is a well-known phenomena throughout human history. Every culture had their own practice of it and methods to do so. Almost always for “practical reasons” of ensuring food for the children, utility of a girl vs. a boy, etc.

We clearly are still in the process of outgrowing this animalistic behavior.

1 Like
13

I happen to live in Tennessee. The way that the law was codified means that women have to be in organ failure to receive medical permission for an abortion. A doctor, knowing that organs will begin to fail, is unable to prescribe an abortion.

There are also women that simply do not have the economic means to travel out of state for a medical necessary abortion, denying a patient the right to do something that may be harmful to them, but in doing reduces a greater harm is a tenant of the current Republican party (the right to try, enacted under the Trump administration.)

Enacting a federal standard of no abortions after the babies viability meets the needs of the pro-life movement. It is not unreasonable to call an abortion of a viable baby murder, it is murder. Greater federal clarity on the guardrails for abortions would meet their deeply held beliefs and desires to advocate for the unborn.

I don’t believe drilling down to the city level is necessary. Counties are well established and unique in their own identity. I live in a larger county that is predominated by a major metropolitan city. Our ballot measures are very nuanced and more frequent compared to a smaller rural county.

County level ensures that all women have access to abortion in a reasonable timeframe without egregious economic prejudice.

I think it’s safe to say that abortion is a deeply rooted issue that requires a special treatment. We once had an issue this divisive; it was slavery. Ratified in our founding document was the 3/5th compromise. Isn’t that clearly a very nuanced solution for a very nuanced problem?

Given a long enough time frame we collectively made the right choice and abolished the practice. But in the interim we had to find a way for consensus. I believe abortion very much falls into that same ballpark.

14

I received a wide variety of responses in the comment section and I responded to the common objections. (For example, people who don’t support the rape exception, or claim that my bill funds murder, or they claim that my bill is too much “compromise”.) You might be interested in reviewing those, too, in order to gauge my full thoughts on your comments. I personally feel that all forms of elective abortion are wrong, but I explained my proposal in mostly practical ways.

2 Likes
15

If your goal is to “ensure all women have access to abortion in a reasonable timeframe without egregious economic prejudice”, then you might as well advocate for federally-mandated abortion standards.

That is what you are basically doing here - you are trying to have your cake and eat it too, undermining the state’s ability to set their own policy while trying to claim that you are somehow respecting state’s rights to set their own policy on abortion.

2 Likes
16

My policy proposal further zooms into a states natural sovereignty and allows for more choice at an even more localized level.

I’d rather live in a world where we don’t have states voting to redraw their boundaries because the blue cities are leading them off of a cliff.

This “cede no ground” thinking is going to create some deep fractures that will result in states seceding from the union. I’m sure we’d come back together eventually, but I see it as an unnecessary reality.

17

That doesn’t follow, given that this policy would create an unprecedented mandate allowing counties to overrule constitutional state law.

1 Like
18

The constitutional state law would be to allow these decisions to be made at the county level.

Unprecedented? Sure.

So was the 3/5th compromise.

19

Steve, none of the pro-life laws require that the risk to the mother’s life be “imminent” or that her symptoms have to be show before intervening. This is a dangerous lie that democrats and abortion advocates have repeated so much that the public accepts this lie as a fact. These treatment delays are endangering women’s lives and amounts to medical malpractice.

Courts, lawyers, OBGYN’s, etc. have repeatedly pointed this out. However, pro-abortion people have repeatedly tried to silence and ignore those voices, on a systemic level & ACOG is in on that.

I have binge-researched this issue. For more details, and all my links about it, see this google doc: Treatment delays for pregnant women in red states

3 Likes
20

I’m sorry, but I don’t understand what you’re trying to say here.

Technically speaking, the 3/5th compromise was the precedent. And…

No, the 3/5th compromise wasn’t a ‘nuanced solution’. It was basically a way of tabling the issue of slavery till a later date (if you want to put it in blunt, ugly terms: “we’ll let future generations sort this out”) because the Founding Fathers gave priority to the issue of actually having a unified country in the face of Britain denying them their country over the issue of solving slavery right then and there.

It was also expected that slavery would end naturally, but the intent that slavery would go away naturally was upended by scientific and economic developments that the Founding Fathers didn’t anticipate.

And despite the best efforts of the Founding Fathers, the issues that were tabled by the 3/5th compromise ultimately split the country in half anyway.

If anything, this proposal you’ve presented would only make the issue worse, not better.

21

There currently is a 2.2b sidewalk proposal for my city. We are also debating a 2.7b new football stadium. These are very nuanced proposals that small rural municipalities do not have to address. The needs of the electorate are fundamentally categorically different based on a 45 minute boundary.

Exactly, we came across a problem that was not able to be solved at the moment to satisfy the desires of all people. So we took an extreme precedent and agreed to codify representation of slaves into the constitution.

That is precisely my argument. The issue of abortion will not be solved at the federal level or by passing it to the state level. I recommend that we punt the problem by moving it to the county level until this practice naturally falls out of favor.

I see abortion as a red herring that will come to bite us all in the proverbial ass if we continue to think in a dualistic way of “pro-life” vs. “pro-choice”.

22

My longer post addressing my previous assertion is awaiting approval.

I’m currently reading thru your google doc.

You certainly are giving me much to think about and I very much appreciate your perspective on this. You’ve clearly spent a tremendous amount of time thinking about this issue.

1 Like