Obviously sites not based in the US don’t have to follow US laws. And obviously using a VPN circumvents local laws. Again, I’m not going to do any of this, but you answered your own question: one way the US could enforce this would be to require ISPs to block targeted advertising, regardless of where the originating site is located.
No, that’s a straw man. For the fifth(?) time, whether it’s foreign or not is irrelevant, and only you suggested they’re evil. The criteria proposed was whether it’s targeted based on personal content or not, and I’m not alone in not liking where we already are in terms of privacy. Are you suggesting that we need to protect foreign advertiser’s rights to your personal content so they can target ads personalized for you? Why? Are you a foreign advertiser?
People accessing sites in other countries via VPN proves absolutely nothing. We are talking about what would happen on US based sites like Google and YouTube, sites that don’t and can’t ignore US law.