On Rfk Jr., Sen. Bill Cassidy Has To Decide Which Of His Careers Comes First

Bill Cassidy is deeply torn over what to do about Robert F. Kennedy Jr.

As a doctor who once prescribed life-saving vaccines, Cassidy is troubled about putting someone in charge of the nation’s health agencies who has claimed, in defiance of the scientific consensus, that the shots are dangerous.

But as a senator facing reelection next year in deep red Louisiana, a state President Donald Trump won by more than 22 points, he has a lot of reasons to vote “yes” for Trump’s choice to lead the Department of Health and Human Services. Cassidy chairs the Senate committee in charge of health policy and likely holds the deciding vote on the Finance panel that will decide whether to recommend Kennedy’s nomination to the full Senate.

“My responsibility is to learn — try and determine — if you can be trusted to support the best public health, a worthy movement called MAHA to improve the health of Americans, or to undermine it, always asking for more evidence and never accepting the evidence that is there,” Cassidy told Kennedy during a health committee hearing last week, referencing Kennedy’s “Make America Healthy Again” movement. “That is why I have been struggling with your nomination.”

Cassidy will have to decide by Tuesday morning: That’s when Finance is scheduled to vote. Cassidy and Kennedy have spoken since the health committee met last week and Majority Leader John Thune told POLITICO key lawmakers are in discussion.

At stake is Kennedy’s sweeping policy agenda, which involves marshaling resources to tackle chronic disease and reframing the government’s role in America’s health.

Cassidy’s political future is at stake, too.

His relationship with Trump’s most vociferous backers is already strained because Cassidy voted to convict the president for instigating the violent riot at the Capitol on Jan. 6, 2021. A vote against a Trump nominee could further cement his reputation as someone hostile to Trump and his agenda.

On Finance, Cassidy will cast the deciding vote if Democrats are as united in opposing Kennedy as they seem — the committee’s rules specify that just one “no” vote from the majority party will mean Kennedy can’t advance to the Senate floor with the panel’s endorsement.

Failing to win the panel’s approval isn’t necessarily fatal to Kennedy’s chances for confirmation, but it might be. Thune has appeared skeptical that another Trump pick, his choice to lead the nation’s intelligence agencies, Tulsi Gabbard, would make it to the floor without a favorable recommendation from the Intelligence Committee.

One Republican, John Fleming, has already jumped in to challenge Cassidy for the party’s Senate nomination next year. Fleming, who served four terms representing a western Louisiana district in the House, cited Cassidy’s impeachment vote in announcing his bid last month.

Cassidy pleaded with Kennedy last week at a hearing of the Health, Education, Labor and Pensions Committee that Cassidy chairs to renounce his anti-vaccine activism. Kennedy for years sowed doubt above vaccine safety at his nonprofit Children’s Health Defense. To Cassidy’s dismay, Kennedy declined, prompting the senator to reach out to Kennedy to talk more over the weekend.

“He’s a Trump supporter,” said a physician and health policy expert who has worked closely with Cassidy whom POLITICO granted anonymity to speak candidly about him. “At the same time, he’s struggling with his obligations as HELP chair and in his Senate post with what is best for the health of Americans.”

Cassidy recounted a heart-rending anecdote about a patient who nearly died of liver failure from hepatitis B in explaining to Kennedy why he feels so strongly. The situation could have been avoided with “$50 of vaccines,” Cassidy said.

Noting the hearing room full of Kennedy supporters — and that the phones in his office were ringing with calls from backers of Kennedy’s MAHA movement — Cassidy said Kennedy would have tremendous influence to encourage, or discourage, vaccination as secretary of Health and Human Services.

Cassidy said his training as a physician — including his oath to do no harm — remains a key part of his thinking as a senator. “That ethic guides me now,” he said.

Despite Cassidy’s imploring — and the evidence he presented supporting vaccines — Kennedy would only say that he’d continue to review the research and apologize if he was wrong.

“I’m a doc, trying to understand,” Cassidy said. “Convince me that you will become the public health advocate, but not just churn the old information so that there’s never a conclusion.”

But Cassidy’s political opponents say that he might as well forget a third Senate term if he bucks Trump again.

That was the gist of the message from another Louisiana Republican, Rep. Clay Higgins, who threatened Cassidy on X after the health panel’s hearing: “We’re saving the country and RFK is part of the formula. So, vote your conscience Senator, or don’t. Either way, We’re watching.”

Paging Dr. Cassidy

Before entering politics, Cassidy was a liver doctor, or gastroenterologist.

He created a program to vaccinate nearly 36,000 children in and around Baton Rouge, Louisiana, against hep B. He pushed increased funding for vaccinations first during three House terms representing a majority-Black district that stretches from Baton Rouge northwest to Shreveport. In 2014 he defeated incumbent Democrat Mary Landrieu and has since celebrated public funding to better understand vaccine hesitancy in the Senate.

He urged the public to get the Covid-19 vaccine — a shot that Kennedy once decried as “the deadliest vaccine ever made.”

But Dr. Cassidy is also Sen. Cassidy.

Kennedy acolytes are pressuring Cassidy, arguing the confirmation vote is one of “spiritual” importance and promising to support a challenge next year if Cassidy votes no.

At the same time, groups opposed to Kennedy from both the left and the right have also lobbied Cassidy.

Last week, the Democratically aligned health advocacy group Protect Our Care launched a digital advertising campaign in Louisiana and other states calling Kennedy “reckless and dangerous.” The ads in Louisiana asked Cassidy’s constituents to urge him to reject Kennedy.

Meanwhile, Advancing American Freedom, a conservative group co-founded by former Vice President Mike Pence, has written to Cassidy urging him to reject Kennedy. The letter cited Kennedy’s opposition to vaccination, his former addiction to heroin and his support for marijuana and psychedelic drug legalization and abortion rights.

A former Cassidy aide granted anonymity to discuss a sensitive decision told POLITICO his onetime boss was well equipped to handle the pressure. “I’ve never known him to get nervous or rattled,” the former aide said. “He is a medical doctor with experience in critical situations that have life-altering implications. He does not let criticism or pressure get in the way of advancing what he believes is the right public policy outcome.”

Trump’s shadow

Vice President JD Vance is lobbying GOP senators to back Kennedy, reprising a role he played for Defense Secretary Pete Hegseth.

If Kennedy makes it to the Senate floor, he can only afford to lose three Republican votes if every member of the Democratic caucus votes no. That was the case for Hegseth. Vance stepped in to break the 50-50 tie and send Hegseth to the Pentagon.

Kennedy is not planning to ask Trump specifically for help, Kennedy’s advisers said — largely because, within Kennedy’s orbit, there’s no consensus on whether Trump’s involvement would do much good, given his frosty relationship with Cassidy.

Things with Cassidy “are very, very problematic with Trump,” said one Kennedy adviser, granted anonymity to share private conversations, “because of the impeachment [vote].”

Kennedy’s allies on Friday projected optimism about his chances, despite the combative tone that dominated much of the six hours of confirmation hearings last week.

“This is a doctor — he takes public health really seriously,” Calley Means, an adviser to Kennedy, said of Cassidy on Fox News. “This is going to be the best vote of Sen. Cassidy’s career. This is going to be a turning point in American history.”

On Sunday, Cassidy, still mum about his intentions, posted a Bible verse on X: “Joshua said to them, ‘Do not be afraid; do not be discouraged. Be strong and courageous. This is what the LORD will do to all the enemies you are going to fight.’”

Ben Leonard, Jordain Carney and Adam Cancryn contributed to this report.