Sen. Bill Cassidy publicly struggled with whether to back Robert F. Kennedy Jr. to lead the Department of Health and Human Services before he fell in line behind President Donald Trump's pick.
It may have done little to help him politically.
Cassidy, R-La., hasn’t formally announced whether he will seek re-election next year, though he has signaled that he intends to run. Problems await him if he does.
The never-doubt-Donald-Trump wing of the Republican Party has yet to forgive Cassidy for having voted in 2021 to convict Trump on impeachment charges that he incited the Jan. 6 Capitol riot. Cassidy already has at least one primary challenger should he seek a third term, and others are waiting in the wings.
"It’s no secret. It’s going to be a tough primary for him,” Louisiana GOP chair Derek Babcock said.
Babcock was among the Louisiana officials who publicly and privately pushed Cassidy to back Kennedy, arguing that a vote for the controversial pick would reflect the will of Louisianans who backed Trump by 19 points in November.
Cassidy questioned Kennedy extensively about his history of denying vaccine efficacy, his record of falsely linking vaccines to autism and his knowledge of Medicaid and Medicare. Cassidy warned that, as a doctor, he felt compelled to rigorously vet the man seeking the most powerful health position in government. Ultimately, Cassidy got to yes and voted to confirm Kennedy on Thursday morning.
“Mr. Kennedy and the administration committed that he and I would have an unprecedentedly close, collaborative working relationship if he is confirmed,” Cassidy said on the Senate floor last week as he explained his decision. “We will meet or speak multiple times a month. This collaboration will allow us to work well together and therefore to be more effective.”
But in Louisiana, the political damage may already have been done.
Cassidy was one of just seven Senate Republicans who voted to convict Trump after his second impeachment. Most of the others resigned or retired in the years since. It’s something his party hasn’t taken lightly — and hasn’t forgotten.
Louisiana’s Republican Party quickly voted to censure Cassidy in 2021. Last year, he criticized Trump again, calling his rhetoric about immigrants “dehumanizing” and questioning his run for president.
While Cassidy has since tried to move back into Trump’s good graces, some Republicans in his state doubt he can overcome an act of disloyalty. Today, Trump has accumulated more power than ever, with few members of his party in Congress pushing back against his taking a bulldozer to the government even while, at times, he clashes with court orders.
“Perhaps his time has come to move on,” Eric Skrmetta, a Republican who serves on the Louisiana Public Service Commission and is weighing a run for the Senate, said of Cassidy. “People forgive if you say you’re wrong, but that has not happened.”
Cassidy’s second-guessing of Trump’s picking Kennedy may have only further hindered a potential re-election run, a challenger contended.
State Treasurer John Fleming, who announced in December that he would seek Cassidy’s seat in 2026, denounced Cassidy’s intense questioning of Kennedy, saying the senator threatened the fate of Trump’s pick to run HHS.
“It was obviously a very close call; he didn’t even commit to supporting Kennedy until just before he voted for him. So we’ve gone days with the media speculating where he would be,” Fleming said in an interview. “People in Louisiana, many of the voters ... told me they’re not going to vote for him next time because they thought that he was inappropriately resisting supporting Kennedy.”
(Cassidy voted against Xavier Becerra, former President Joe Biden’s pick to run the department during his administration.)
Meanwhile, Fleming characterized Cassidy’s vote to convict Trump in 2021 as akin to an unforgivable sin.
“The only reason to have done that was to foreclose the possibility that Trump could run for re-election,” Fleming said. “We would have President Biden or President Harris today if he and some of his colleagues had been successful.”
Fleming, who also made an unsuccessful run for the Senate in 2016, is the only announced challenger to Cassidy. But other Republicans, including Skrmetta, the public service commissioner, could jump into the race. State Sen. Blake Miguez is also reportedly considering a run.
Skrmetta said his decision will depend on Trump’s endorsement, saying he has “opened the dialogue” with Trump’s team about the race. Several Trump spokespeople didn’t respond to questions about his position on Cassidy.
“If the president endorses, I’m going to get behind the person he endorses, whether that’s me or someone else,” Skrmetta said.
While Trump looms over the primary, Cassidy will also have to contend with a new primary process, which some Louisiana political strategists say could put him at a disadvantage.
Republican Gov. Jeff Landry led an effort last year to institute a more traditional primary system for congressional races. In the new system, candidates from the same party compete for the nomination, with a runoff if no candidate wins a majority of the vote among voters registered with their party or unaffiliated voters, who can cast primary ballots.
Louisiana previously had a so-called jungle primary, in which candidates from all parties competed on the same ballot for support from all registered voters. A candidate could win outright with a majority of those November votes, but in the absence of an outright win, the top two vote-getters regardless of party advanced to a runoff in December.
Even though unaffiliated voters can vote in the new primary system, the partisan primary means Cassidy will also have to win over the party’s more conservative base to secure the nomination.
“It’s probably going to be a lot of the pro-Trump voters for sure. They’re very motivated to go out and vote,” Babcock, the state GOP chairman, said of the expected primary electorate. Babcock said that it isn’t clear yet whether the party will endorse a candidate ahead of the primary but that the “general sense” among many party members is to let the primary play out.
It’s rare for a sitting senator to lose a primary, and Cassidy has signaled that he is gearing up for a competitive race. His campaign touted his recent fundraising haul, ending the year with $6.6 million in his campaign account.
As chairman of the Senate Health, Education, Labor and Pensions Committee, Cassidy can also tout the power he has built up over his years in Congress and stress the federal dollars he has brought to the state.
“You can’t ignore the fact that he’s a high-ranking member of the Senate now, and he has a lot of weight. ... So he has that going for him,” said longtime Louisiana pollster Bernie Pinsonat, who has worked for candidates from both parties.
Still, Cassidy could face a tough fight as his opponents remind Trump voters of his impeachment vote.
“Sen. Cassidy burned many, many bridges in Louisiana when he voted for President Trump’s impeachment, the second impeachment,” Louisiana Republican strategist James Hartman said. “And Trump voters have long memories.”
