This enforcement action scores 31.4 on constitutional damage through aggressive cross-state prosecution targeting abortion access (civil_rights:4.5, rule_of_law:4.0). The indictment of a NY doctor for prescribing to Louisiana patients creates precedent for interstate medical prosecution, threatening federalism and reproductive rights. Enforcement_action mechanism adds 1.25x modifier; single_state scope reduces to 0.85x. Severity multipliers reflect moderate durability (1.2), partial reversibility (1.1), and significant precedent risk (1.2). B-score of 35.6 driven by high outrage potential (8.5) in abortion context, strong timing alignment with Trump administration enforcement priorities (8.0), and clear mismatch between telemedicine norm and selective prosecution (7.0). Intentionality score of 11 (73% weight) reflects political timing, symbolic targeting of abortion access, prosecutorial discretion, and narrative alignment with anti-abortion agenda. D-score of -4.2 indicates slight distraction lean, but both scores exceed 25 threshold, qualifying as Mixed with B-list lean due to strategic enforcement timing and high hype generation around abortion flashpoint.