Redditors want to pretend he’s simply dumb, but when you get past the memes, what he’s ultimately saying is “I promise to give my friends the nice fancy rich people kind of women’s health care, while staunchly defending the right to brutalize my enemies for trying to access the mean ugly poor people kind of women’s health care.”
The policy he’s promising is consistent with what the Republican Party (and the Anti-Abortion wing of the Democratic Party) have always held to. You’ll get care commensurate with your social status. The abortion equivalent of Jim Crow.