Betrayed by RFK Jr., targeted by Trump, Bill Cassidy faces voters

BATON ROUGE, La. — When it comes to Bill Cassidy, most everyone in Louisiana politics — supporters and detractors alike — feels bad for the senator.

For his 20 years in politics, he’s mostly been a doctor in lawmaker’s clothing: evidence-obsessed, carefully calculating the right policy prescriptions for the issues before him, according to more than a dozen people who’ve worked with or for him. Those traits, along with his firsthand knowledge of America’s health care system, made him a respected leader on the subject in the Capitol. 

He could be at the zenith of his power: He’s leading the Senate committee that oversees health policy, with Republicans in charge across the federal government and health care affordability emerging as the top political issue ahead of the midterm elections. He’s led the GOP in health reform plans for nearly a decade, and his recent policy proposals are, at times, more Trump-aligned than those of many colleagues.

Instead, Cassidy, 68, has increasingly set aside his health policy credentials in favor of proving his MAGA bona fides. He’s facing a tooth-and-nail primary fight on May 16 to keep his Senate seat, with President Trump and the politically ascendant Make American Healthy Again movement endorsing one of his challengers.

In some polls, Cassidy is trailing his rivals — Trump-backed Rep. Julia Letlow and John Fleming, Louisiana state treasurer — though the data is far from definitive.

But win or lose, Cassidy’s friends, allies, and critics told STAT that the senator seems unlikely to ever fully recover from his collapse in stature and power as the changed political landscape demands that Republican lawmakers either be all in on Trump or cast aside. Cassidy has tried to play both sides: voting, his friends say, with his conscience as a physician while also trying to support the president. The result is a party that accuses him of being a Republican in name only for casting a crucial vote against Trump — and a health care establishment appalled by what it sees as a betrayal of his Hippocratic oath and an erosion of his own legacy.