In Louisiana primary, a senator-physician tries to survive Trump鈥檚 ire
| Metairie, La.
Sen. Bill Cassidy doesn鈥檛 think about Jan. 6, 2021, the day supporters of President Donald Trump stormed the U.S. Capitol. The Louisiana Republican says he doesn鈥檛 鈥渟it around constantly mulling over the past like Lady Macbeth.鈥� Or rewatch the selfie video from inside the Capitol, where he called on the 鈥溾�� to 鈥淪top, period鈥� and allow the peaceful transfer of power.
And he certainly doesn鈥檛 sit around thinking about the impeachment vote he cast a little over a month later, in which he, along with six other Republicans and all Democrats, found President Trump guilty of 鈥渋ncitement of insurrection.鈥� (The Senate ultimately did not convict Mr. Trump.)
鈥淵ou make a decision based on facts, and you move on,鈥� says Senator Cassidy, as he works a room full of blazer- and kitten-heel-wearing supporters at a seafood restaurant outside New Orleans. He shakes hands, cracks dad jokes, and talks about the things he says actually do keep him up at night, such as flood management and healthcare reform.
Why We Wrote This
GOP Sen. Bill Cassidy voted to convict Donald Trump in the 2021 impeachment trial and has pushed back on public health matters. His fate on Saturday will signal the clout of the Make America Healthy Again movement, as well as the president鈥檚 hold on his party.
Mr. Trump hasn鈥檛 moved on in the same way. The president, who demands total loyalty from Republicans in Congress, has made unseating the two-term senator in Saturday鈥檚 Louisiana primary a priority.
It鈥檚 not just the impeachment vote that has drawn Mr. Trump鈥檚 ire. There have been other dustups between the senator and the White House in the president鈥檚 second term 鈥� particularly over public health. During Robert F. Kennedy Jr.鈥檚 hearing to become secretary of Health and Human Services, Dr. Cassidy, a physician, challenged the vaccine skeptic on a number of fronts.聽And in the year since, he has continued to question many of Mr. Kennedy鈥檚 decisions and opinions.
As far as Trump pushback goes, Dr. Cassidy鈥檚 was hardly the most forceful: He eventually cast the tiebreaking committee vote that cleared the way for Mr. Kennedy鈥檚 confirmation. Still, he dragged his feet long enough to 鈥渕ake both sides mad,鈥� says Louisiana Treasurer John Fleming, who is running to replace the senator. Mr. Trump has endorsed a third Republican in the race, Louisiana Rep. Julia Letlow, who has the support of Mr. Kennedy鈥檚 MAHA (Make America Healthy Again) movement.
All of which could make Saturday鈥檚 primary even more telling. Even as Mr. Trump鈥檚 own poll numbers hit new lows amid rising prices and an unpopular war in Iran, his hold on his party has shown little sign of abating. His ability to punish errant Republicans was brought home just last week in Indiana, where state lawmakers who had resisted his redistricting demands lost seats to primary opponents. Dr. Cassidy is a much bigger, and potentially riskier, target 鈥� a two-term senator with a track record of delivering for his state. His fate will signal the clout of the still-young MAHA movement within the GOP as well as the president鈥檚 power as Mr. Trump heads into the lame-duck years of his final term.
鈥淚n such a frustrated and polarized society that we live in today, sometimes what we鈥檙e against is what stands out,鈥� says Denham Springs City Council member Jim Gilbert before introducing Dr. Cassidy at a Baton Rouge campaign event. 鈥淎nd not what we鈥檙e for.鈥�
A three-way split
Recent Dr. Cassidy is in the race of his political life. A late April has the senator trailing both Dr. Fleming, a physician like Dr. Cassidy, and Ms. Letlow, with 21% of the vote to their 28% and 27%, respectively. It鈥檚 possible the sitting senator won鈥檛 even make it to the all-but-guaranteed June runoff if no candidate passes the 50% threshold this Saturday.
Likely hurting Dr. Cassidy are changes to Louisiana鈥檚 elections. The state used to hold a 鈥渏ungle鈥� primary, where all candidates for an office appear on the ballot together, regardless of party. This year, Louisiana moved to a more typical party primary, which often favors candidates on the far ends of the ideological spectrum. Some speculate that GOP Gov. Jeff Landry, an ally of the president, pushed through this change deliberately to help Dr. Cassidy鈥檚 opponents.
Things took another turn last month when the U.S. Supreme Court struck down Louisiana鈥檚 congressional map. In response, Governor Landry postponed the state鈥檚 House primary vote until this summer, but left the Senate primary on May 16. Both Dr. Cassidy and Dr. Fleming worry that the changes will cause confusion for voters.
Dr. Cassidy tells the Monitor he believes the race will ultimately be decided on 鈥渨ho delivered鈥� for the state. For voters concerned about 鈥渉ow well I work with President Trump,鈥� Dr. Cassidy points to bills he worked on that the president signed into law, like the HALT Fentanyl Act, or the 鈥渘o tax on tips鈥� part of Mr. Trump鈥檚 One Big Beautiful Bill. He also frequently references the $13.5 billion he brought to Louisiana as a lead negotiator for former President Joe Biden鈥檚 Infrastructure Investment and Jobs Act, which is a frequent source of criticism from his opponents.
Mr. Gilbert, the Denham Springs council member, talks about how quickly the senator secured federal funds for his city when it flooded in 2016. Grant Parish Sheriff Steven McCain says after his parish flooded, the senator helped them get boats to navigate the water-covered, hilly terrain. Supporters across the state emphasize how Louisianans benefit from the senator鈥檚 position as chair of the powerful Health, Education, Labor, and Pensions Committee.
To which Dr. Cassidy鈥檚 opponents have a ready response.
鈥淣one of that matters,鈥� Ms. Letlow tells the Monitor bluntly, 鈥渋f you don鈥檛 have access to the president.鈥�
鈥淚 like Trump鈥�
Mr. Trump called Ms. Letlow personally to ask her to get into the race against Dr. Cassidy. He followed that up with an endorsement on Truth Social () days before she made her campaign official in January. The president鈥檚 support for Ms. Letlow goes back to her first campaign in 2021, when she ran in a special election to fill the seat of her late husband, Luke Letlow, who died of COVID-19 shortly after being elected in 2020. She was reelected in Louisiana鈥檚 5th Congressional District, the rural northeastern corner of the state, again in 2022 and 2024.
In an interview after speaking to two dozen members of a Rotary club in rural Crowley, nicknamed 鈥渢he Rice Capital of the World,鈥� Ms. Letlow attributes the president鈥檚 endorsement to loyalty. 鈥淗e knows he can count on me,鈥� she says.
Leaning on the hood of his car across the parking lot, GOP voter James Webb gives a similar reason for jumping ship from Dr. Cassidy to Ms. Letlow: 鈥淚 like Trump,鈥� he says, throwing up his hands both literally and figuratively.
鈥淧resident Trump is very well liked in Grant Parish,鈥� says Sheriff McCain, a Cassidy supporter, adding that the president鈥檚 endorsement 鈥渃arries a lot of weight.鈥� i
Mr. Trump won the state by roughly 20 points in each of his three presidential elections. But the Bayou State has also shown strong support over the years for Dr. Cassidy, a former state senator who defeated a Democratic incumbent to win Louisiana鈥檚 6th Congressional District in 2008 and defeated a Democratic incumbent again in 2014 when he first ran for Senate. The first Republican to hold the seat , Dr. Cassidy won reelection in 2020 (with Mr. Trump鈥檚 endorsement) with of the vote against 14 opponents.
A Cassidy campaign flyer shows the senator standing behind Mr. Trump in the Oval Office. And attendees at his events, many wearing 鈥淕eaux Bill鈥� buttons, downplay any conflict between the senator and the president. The impeachment vote 鈥渨as a little blip,鈥� says Bernard Pentes in Metairie.
For a blip, though, it has had a big ripple effect. Of the seven Republican senators who voted to convict Mr. Trump following the Capitol attack in 2021, only one, Alaska Sen. Lisa Murkowski, has been reelected despite facing a Trump-backed challenger. Three others retired, one resigned, and Maine Sen. Susan Collins will have her own existential race this year, although she did not face a serious primary challenge.
After the impeachment vote, 鈥渋t really seemed obvious that [Cassidy] was going to have real trouble running for reelection,鈥� Dr. Fleming tells the Monitor in a Baton Rouge coffee shop.
The four-term congressman and House Freedom Caucus co-founder had opted out of a Senate run in 2014 after Dr. Cassidy announced his own campaign, not wanting to 鈥溾�� between two Republicans that could benefit the Democratic incumbent. This year, Dr. Fleming decided Dr. Cassidy was 鈥渂eatable.鈥�
鈥淭he Republicans in this state are some of the most conservative voters in the country,鈥� says Woody Jenkins, a Republican who served in the Louisiana House of Representatives for almost 30 years and ran several of his own close campaigns for Senate. He calls the impeachment vote a 鈥渘ail in the coffin鈥� for Dr. Cassidy, saying: 鈥淗e showed his true colors at that moment.鈥�
Mr. Jenkins adds: 鈥淭hen we had the pandemic.鈥�
MAHA and vaccines
One big frustration for the Cassidy campaign is that many voters wrongly accuse the senator of having supported COVID-19 vaccine mandates.
鈥淧eople should get vaccinated for COVID-19, but the government ,鈥� Dr. Cassidy said in 2021.
And despite the MAHA wedge in this primary race, his opponents shared a similar position. In 2021, Ms. Letlow said she 鈥渨ould have given everything鈥� for the COVID-19 vaccine to have been available for her husband. When asked if her support for the vaccine puts her at odds with her MAHA supporters, the congresswoman responds that she 鈥渘ever said that vaccines should be mandated.鈥�
Dr. Fleming says he is 鈥渘ot an anti-vaxxer at all,鈥� and tells all his patients, children, and grandchildren to get vaccinated, but is opposed to vaccine mandates. He says he does not agree with 鈥渆verything鈥� that Mr. Kennedy says or believes, and that some of his 鈥渋deas about vaccines鈥� are 鈥渞eally out of the mainstream.鈥� But he also says he supports all of the president鈥檚 Cabinet choices and 鈥渃an鈥檛 think of anything鈥� that Mr. Trump has done that he would push back on.
When Dr. Cassidy announced his vote to confirm Mr. Kennedy, he said he had been given assurances of a 鈥�,鈥� with input on HHS hiring decisions. Other commitments, he said, included keeping the Centers for Disease Control and Prevention鈥檚 advisory committee on vaccines intact.
But the HHS secretary went on to for the vaccine panel, which then voted to withdraw a recommendation for the Hepatitis B vaccine 鈥� a move Dr. Cassidy called a 鈥�.鈥� During his medical career, Dr. Cassidy, a liver specialist, had created a program to provide the Hepatitis B vaccine to in Baton Rouge.
On the CDC鈥檚 vaccine safety web page today, an asterisk on the headline 鈥淰accines do not cause autism鈥� clarifies that it 鈥渉as not been removed due to an agreement with the chair of the U.S. Senate Health, Education, Labor, and Pensions Committee that it would remain on the CDC website.鈥�
In recent months, Dr. Cassidy has continued to challenge Mr. Kennedy鈥檚 moves at HHS in . At the end of April, Mr. Trump Dr. Cassidy directly (鈥渁 very disloyal person鈥�) for the stalled nomination of the president鈥檚 original pick for U.S. surgeon general, MAHA influencer Casey Means.
Taking the stage in Baton Rouge, Dr. Cassidy talks about the need for courage in politics. When he鈥檚 finished, reporters ask if he was referencing his impeachment vote. Or perhaps his pushback to Mr. Kennedy? Actually, Dr. Cassidy says, he was thinking about his vote for Mr. Biden鈥檚 infrastructure bill. But, sure, he adds, the same point could apply to all those things.
鈥淒o I get criticized? Yes,鈥� he says. 鈥淚f you don鈥檛 want to get criticized, don鈥檛 run for Senate.鈥�
