RFK Jr. vote poses key test for Bill Cassidy, endangered Louisiana senator

Lauren Weber
The Washington Post

Robert F. Kennedy Jr.’s bid to serve as America’s top health official could come down to a Louisiana Republican who’s openly wrestling with his training as a physician and his instincts as a politician.

Sen. Bill Cassidy (R-Louisiana), who has begged Kennedy to stop invoking the debunked link between vaccines and autism, is seen as one of several swing votes on Kennedy’s nomination to lead the Department of Health and Human Services. Local and national political leaders, public health experts, and Kennedy supporters have all spent days training their focus on Cassidy, with Kennedy allies hopeful that they’ve won his support after last week’s confirmation hearings. Cassidy also had conversations with Kennedy over the weekend, according to two people who spoke on the condition of anonymity to describe private conversations.

Cassidy’s office declined to comment on whether he will support Kennedy, but his stance will soon become public: He’s a member of the Senate Finance panel set to vote Tuesday on whether to advance Kennedy’s nomination to the Senate floor.

A spokeswoman for Kennedy did not immediately respond to questions about Cassidy’s conversations with Kennedy and whether Kennedy believes that he has won the senator’s vote.

Cassidy questioned Kennedy across two Senate hearings last week and spent much of the second chastising Kennedy for his years of undermining confidence in vaccines. The chairman of the Senate Health Committee reflected on treating a young unvaccinated woman who nearly died of a vaccine-preventable disease — “the worst day of my medical career,” Cassidy said — and his fears that confirming Kennedy to oversee the nation’s health agencies would lead to real harms.

“My concern is that if there is any false note, any undermining of a mama’s trust in vaccines, another person will die from a vaccine-preventable disease,” Cassidy said. He mused on whether the 71-year-old Kennedy was set in his ways — or whether he could “change his attitudes and approach now that he’ll have the most important position influencing vaccine policy in the United States.”

But Cassidy also acknowledged the political realities.

“Let’s be political. I’m a Republican. … I want President Trump’s policies to succeed in making America and Americans more secure, more prosperous, healthier,” he said. Cassidy also hinted at a path toward voting for Kennedy, saying that he supported much of Kennedy’s “Make America Healthy Again” agenda to combat chronic disease. He also spoke of Kennedy’s influential platform and his potential power to restore Americans’ flagging trust in the nation’s public health agencies.

A vote for Kennedy may not be enough to save a senator that President Donald Trump dismissed last year as “a disloyal lightweight” after Cassidy voted to convict Trump on an impeachment charge in 2021 and later said that the former president should not run for reelection. The moves alienated GOP political leaders ahead of Cassidy’s bid to be reelected next year. Ward Baker and Tony Fabrizio, sought-after Republican political consultants who helped manage Cassidy’s 2020 reelection campaign, are no longer working with Cassidy, according to two people who spoke on the condition of anonymity to describe private arrangements.

John Fleming, a former GOP congressman and Trump administration official — and, like Cassidy, a physician — last year declared that he would seek Cassidy’s seat. In an interview with The Washington Post, Fleming said that he would vote for Kennedy and Trump’s other nominees. Asked if he had any concerns about supporting Kennedy given his own medical training, Fleming pointed to Trump’s record of shuffling staff members.

“The thing about Donald Trump that I’m so confident in is that any of the nominees, if they mess up even a little bit, he has no hesitation to replace them,” said Fleming, referencing Trump’s decision to fire his first health secretary, Tom Price, after less than a year.

Bob Mann, a longtime Louisiana political commentator and former aide to Democratic lawmakers, said that Cassidy’s reelection bid was already in “trouble,” independent of his pending vote on Kennedy, particularly after Louisiana revamped its primary system. Unlike Cassidy’s past campaigns, Democrats can no longer cross party lines to vote in Senate primaries.

Mann also said he recently sent an email to Cassidy’s office, urging him to “have the courage to do the right thing” and vote against Kennedy.

“There’s no doubt in anyone’s mind that Cassidy knows that RFK is unqualified for this job,” Mann said.

The Kennedy vote is shaping up as a first test of Cassidy’s new role as Senate Health Committee chairman, a prized perch that puts him in position to shape Congress’ health-care legislation — and potentially be a key Trump ally. His predecessor as chairman, Sen. Bernie Sanders (I-Vermont), forged a partnership with President Joe Biden that helped lead to Medicare drug price negotiation and other policies that Democrats have touted as key victories of the Biden term.

Friends, aides and colleagues have said the opportunity to delve into the details of complicated health policy suits Cassidy — a professorial lawmaker who has used a whiteboard to walk reporters through the intricacies of his plans. In interviews, they shared stories of Cassidy becoming excited by academic papers, sparring with experts over wonky details — and performing small, unseen acts of civic responsibility, such as picking up trash as he walks through the U.S. Capitol.

Cassidy has been in the spotlight before. As a first-term senator, his proposal to repeal and replace the Affordable Care Act in 2017 thrust him into the middle of a national debate over the health law.

Liberal-leaning advocacy groups such as Protect Our Care ran ads attacking Cassidy’s plans, and late-night host Jimmy Kimmel spent several days mocking Cassidy and even sparring with him in a national TV segment. Sanders peppered Cassidy with questions in a CNN debate, urging Republicans to not “throw the baby out with the bathwater.” The plan died.

Now, many of those same liberals are counting on a lawmaker they once derided to help block Kennedy’s confirmation.

“I find myself in the unusual and uncomfortable position of having to agree with Senator Cassidy’s line of questioning,” Sanders said, marveling at their similar approaches to Kennedy last week.

Leslie Dach, the co-founder of Protect Our Care — which is running a “Stop RFK” war room and has spent more than $1 million on the confirmation fight, including on ads intended to sway Cassidy — praised the Republican senator as thoughtful and principled in an interview, saying that Cassidy realized that his ACA repeal bill was politically unpopular, so he abandoned it.

“The American people didn’t want that kind of health-care policy,” Dach said in an interview. He then cited recent polling about Kennedy’s nomination, such as a survey from the Associated Press-NORC Center for Public Affairs Research that found 3 in 10 adults approve of the nomination, while about 4 in 10 disapprove of it, arguing it was evidence that Cassidy should again listen to the polls.

Cassidy’s approach to Kennedy has also been praised by some conservatives. National Review, a conservative publication, hailed his questioning of Kennedy last week as the senator’s “finest hour,” saying that he deftly made his points about Kennedy’s lack of fitness for the role.

As Cassidy wrestles with his political future, he is facing growing pressure to support Kennedy from prominent Republicans in his home state, which backed Trump by more than 20 percentage points.

“A new perspective is needed to address the health crisis our nation is facing,” Louisiana Gov. Jeff Landry (R) wrote in a letter to Cassidy and Senate Majority Leader John Thune (R-South Dakota) urging the swift confirmation of Kennedy.

In 2021, Kennedy called coronavirus vaccines the “deadliest vaccine ever made” at a Louisiana House hearing on a state health department proposal to require that schoolchildren be vaccinated against the virus. Conservative Republicans in the state cited Kennedy’s visit to the state in a letter asking Cassidy to support the nominee.

“Then, as now, Mr. Kennedy displayed sincere concern about the well-being of American children, especially regarding unwarranted, untested, and unsafe medical interventions,” the Louisiana lawmakers wrote late last month.

Cassidy knows what it’s like to endure the wrath of Republicans in his deep-red state. He voted to convict Trump on a single article of impeachment in 2021 — a position that prompted him to be censured by the Louisiana Republican Party.

Other Louisianans are hoping he draws a line on Kennedy. More than 100 Louisiana physicians signed on to a letter for Cassidy decrying Kennedy’s nomination, and some have reached out to Cassidy.

Jennifer Herricks, founder of the Louisiana Families for Vaccines advocacy group, which organized the letter, said it was clear watching the hearing that Cassidy was relying on his medical training and connections to question Kennedy. Cassidy mentioned a friend texted him to tell him two children had died recently in a Baton Rouge ICU of vaccine-preventable diseases.

“We’re all just over here, parents in Louisiana and all over the country, putting our trust in Senator Cassidy to protect our kids from the real danger that RFK presents,” Herricks said.

Cassidy has cited his own deep concerns with Kennedy’s nomination, saying he has talked to parents in his state who partly credit Kennedy with the decision not to vaccinate their child. The doctor turned senator repeatedly implored Kennedy to acknowledge the overwhelming evidence that vaccines don’t cause autism.

“I know the data is there,” Cassidy said.

“If you show me data, I’ll be the first person to assure the American people that they need to take those vaccines,” Kennedy replied.

Near the end of the hearing, Kennedy said he would like to show Cassidy a study suggesting the link does exist, citing a recent observational study funded by an anti-vaccine advocacy group and criticized by medical experts for shaky methodology. Cassidy asked him to repeat the name of the study and then fiddled with his computer. Roughly 10 minutes later, Cassidy appeared to have read the study.

“I looked at the article,” Cassidy said, “and it seems to have some issues.”