Florida’s Amendment 4 would enshrine abortion rights in the state constitution. Republican governor Ron DeSantis is deploying every tactic he can to stop it.
Florida governor Ron DeSantis holds a press conference on October 20, 2024, appearing with doctors who oppose a ballot measure that would protect abortion rights. (Paul Hennessy / SOPA Images / LightRocket via Getty Images)
“I’m voting ‘yes’ on Amendment 4, and I’m telling everyone I know to vote ‘yes.’” “I’m voting ‘yes,’ but it will never pass; this is the Bible Belt.” “I’m voting ‘no’ to prevent more babies from being murdered.” These were a few of the responses I heard when phone banking in early October in support of Florida’s Amendment 4 to enshrine abortion rights in the state constitution.
Amendment 4 is a high-stakes ballot initiative with ramifications for the entire South. Until Republican lawmakers passed the six-week abortion ban that went into effect on May 1 of this year, Florida was a destination for many abortion seekers from other states in the South that had already passed six-week restrictions or total bans.
Out-of-state residents fueled an increase in abortions in Florida, even despite the fifteen-week ban that went into effect in July 2022 soon after Roe v. Wade was overturned. Nearly eight thousand people traveled to the state last year for abortion care, according to data from the state Agency for Health Care Administration — a 15 percent increase from the year before. There was an even larger spike in 2022, when out-of-state patient totals were up 38 percent from the previous year. Florida’s role as an important regional provider of reproductive health care makes the outcome of this ballot referendum extremely consequential for women in the South.
If 60 percent of Florida voters support Amendment 4 in the November election, the state constitution will protect abortion rights until fetal viability (usually around twenty-four weeks of pregnancy) “or when necessary to protect the patient’s health, as determined by the patient’s health care provider.”
Since the Dobbs decision overturned Roe v. Wade in 2022, there have been several state ballot referendums in support of abortion rights. Every single one has passed, even in conservative-dominated states like Kansas and Ohio. Florida will be the first to be tested by a 60-percent-majority requirement.
Despite wide support for legal access to abortion among both Democrats and Republicans, the 60 percent threshold required for ballot measures to pass in the state is an enormous challenge for reproductive rights activists. In a recent New York Times and Siena College poll, 46 percent of likely Florida voters said they would vote for Amendment 4 to legalize abortion until fetal liability, while 38 percent said they wouldn’t vote for it and 16 percent said they either didn’t know or refused to answer. Among respondents aged eighteen to twenty-nine years old, 63 percent said they would vote for the amendment, compared to 31 percent who said they would vote “no.”
Support for the amendment was polling much better in the spring, before antiabortion groups launched their initiatives in opposition and before the administration of Florida governor Ron DeSantis fully committed to a deceptive opposition campaign. A June Fox News poll showed 69 percent of Florida voters supported the measure, and a May CBS News poll showed 60 percent of likely Florida voters supported Amendment 4. Those numbers have tanked as the DeSantis administration has pressed its thumb on the scales to defeat the amendment.
A Campaign of Intimidation and Misinformation
Claiming that “a large number of forged signatures or fraudulent petitions” were submitted to get the amendment on the ballot, the Office of Election Crimes and Security, an election police unit created by DeSantis, started investigating 36,000 already verified petitions collected by Floridians Protecting Freedom, which is leading the Amendment 4 effort. Multiple voters who signed the petition reported that police officers showed up at their homes to question them about their Amendment 4 petition signatures, looking into supposed petition fraud. No fraud was found, but voters were left shaken and intimidated.
In September, Florida’s Department of Health launched a website opposing Amendment 4, saying that it “threatens women’s safety” and proclaiming, “We must keep Florida from becoming an abortion tourism destination state.” Supporters of Amendment 4 and some legal experts slammed the website as a misappropriation of state funds for political campaigning. Bacardi Jackson, the executive director of the American Civil Liberties Union of Florida, said that it was “unprecedented for the State to expressly advocate against a citizen-led initiative.”
Florida’s Department of Health also recently sent cease-and-desist letters to dozens of local TV stations, threatening them with criminal proceedings if they continued to run an advertisement in support of Amendment 4. The commercial features a Tallahassee mother describing how she was diagnosed with brain cancer when she was twenty weeks pregnant, just before state abortion restrictions went into effect, and asserting that the current extreme abortion ban would not have allowed her to get the abortion she needed to begin cancer treatment. A federal judge recently issued a temporary restraining order against the Florida Department of Health, calling its legal threats “unconstitutional coercion.”
That’s not the only deceptive trick antiabortion political leaders have used to scare people from supporting Amendment 4. A few months ago, a state panel primarily made up of DeSantis political appointees rewrote the financial impact statement that appears below the amendment on the ballot. The new statement indicates that the amendment could require the state to subsidize abortions with public funds, which would increase costs. It also suggested that additional costs to the state could occur due to expected litigation from those who might challenge existing laws around parental consent for abortion and the requirement that only licensed physicians are legally allowed to perform abortions.
The state panel also highlighted that fewer live births would “be a loss to state and local tax collections beginning immediately and extending over time” and would “exacerbate financial constraints for individual school districts already experiencing a decline in student enrollment.” For Florida Republicans to feign concern for public education after spending years undercutting and underfunding public schools is peak hypocrisy.
Amendment supporters have called out the panel, calling the rewritten financial impact statement a “dirty trick to mislead voters.” The forces against this amendment go further. Powerful right-wing groups like the Heritage Foundation, which is the architect of Project 2025, and Susan B. Anthony Pro-Life America, which is the nation’s largest antiabortion political advocacy organization, presented materials opposing the amendment to the state panel. National antiabortion groups are doing all they can to oppose citizen-led ballot initiatives to enshrine abortion protections in state constitutions, and they have the resources and the moral conviction to use every bureaucratic lever and executive power available — legitimate or not.
Strategy Debates in the Abortion Rights Movement
There’s no question that defeating DeSantis and the antiabortion lobby in Florida is an urgent necessity. If passed, the amendment would restore essential health care access to millions across the South and deal a major blow to the right-wing forces trying to strip away reproductive rights state by state. With that crucial context in mind, Amendment 4 also faces legitimate critiques from abortion rights supporters who want to push for broader protections. These critiques are necessary to engage, as the abortion rights movement is at a critical juncture and must act strategically to prevent the further erosion of abortion rights. With that context in mind, it’s worth examining some of the debates within the movement about the scope of care and movement resources.
Abortion will be on the ballot in nine states other than Florida, including Missouri, Arizona, Nebraska, South Dakota, and Nevada, all states that currently ban or restrict abortion care. Abortion supporters have been divided over the strategy of these state ballot referendums. Most of the current state ballot initiatives protect abortion rights until fetal viability, or about twenty-four weeks of pregnancy, enshrining the former federal protections of Roe v. Wade. But some abortion advocates say that the protections of Roe were too narrow, leaving out the people who need care, for many different reasons, after fetal viability. Limiting polling shows that Americans support legal abortion throughout pregnancy, especially when framed as an entreaty against government interference in health care decisions. Could we be missing an opportunity to expand care to more people because we’re playing it safe and appealing to voters to return to a pre-Dobbs status quo?
By that measure, Amendment 4 is potentially limited, even if it does pass the obstacles put in its path by DeSantis and the antiabortion movement. Florida’s referendum is limited in other ways too: for example, it includes a parental notification requirement for minors, another condition that many abortion supporters are against. Putting obstacles in place for minors will lead to more people being unable to access needed care and could open the door for further antiabortion restrictions. By conceding to concerns about protecting “parental rights,” abortion supporters are choosing not to fight for a large segment of the population who deserve autonomy and support, and legitimizing a conservative talking point that uses children and teen safety to fearmonger and undermine access to reproductive health care.
Additionally, rights do not guarantee access, and Amendment 4 does nothing to provide public funding for those seeking abortion care. Some advocates of the abortion protection state ballot initiatives point to a lack of public support for allowing state Medicaid programs to cover abortion care, especially in Republican-dominated states. But support for overturning the Hyde Amendment, a federal bill that blocks public funding for abortion, has grown in recent years. In 2023, Data for Progress found that 57 percent of voters support repealing the Hyde Amendment through the EACH Act, including 56 percent of independents and 39 percent of Republicans. And unless we use every chance we can to raise awareness about the benefits of expanding social support for reproductive health care, we will never build public support over time.
Another worthwhile strategic critique of the state ballot referendum approach to expanding abortion rights is the sheer amount of money, time, and resources being poured into state campaigns, perhaps at the expense of supporting the needs of patients desperate for abortion care right now. Abortion funds, which provide money for abortion care for those who can’t afford it, as well as travel and childcare costs, are in desperate need of further funding. As abortion bans and restrictions spread across the country, patients are forced to travel farther to seek care, increasing the costs of travel and of the procedure itself if delays add to gestational age.
In August, more than thirty abortion funds across the country signed an op-ed criticizing national reproductive rights organizations for focusing too much on advocacy instead of supporting patient care:
As representatives of local abortion funds across the country, we of course support any political efforts to expand abortion access in the future. But we also want to pose this question to the elite sectors of our movement: Where is your strategy to increase abortion care right now, when it has never been needed more?
It shouldn’t be an either/or situation, but in a movement dominated by national reproductive rights organizations with the majority of the resources and local abortion clinics and funds that provide the majority of the direct care and support to patients, that’s often the reality. Reproductive health advocates speculate that some of the funding that could go toward supporting care for people seeking abortions is being funneled into state amendment campaigns or toward Democrats running on pro-abortion platforms in the upcoming election.
Despite these important strategic questions facing the movement, the immediate priority is clear: Florida residents must seize this chance to defeat DeSantis’s authoritarian machine and protect abortion rights in the state constitution. A win for Amendment 4 would preserve vital health care access for millions of Floridians and others across the South. It would also demonstrate that even in the face of intense state repression and right-wing intimidation, ordinary people can still successfully fight back. The referendum’s limitations shouldn’t overshadow what’s at stake. This is a crucial battle that reproductive rights supporters can’t afford to lose.