Sen.
Ousting the veteran senator would amount to payback for Health and Human Services Secretary Robert F. Kennedy Jr., who has publicly clashed with Cassidy over his anti-vaccine stances and other issues. Cassidy also has earned President Donald Trump’s ire for dragging his feet on aspects of the president’s agenda, such as not bringing MAHA ally Casey Means up for a committee vote for the role of surgeon general.
“Congress is probably the place where the greatest resistance to MAHA lives in DC,” said Mark Gorton, president of the MAHA Institute.
Polling in the race has been partisan and erratic, but some surveys have shown Cassidy trailing both Letlow and Louisiana Treasurer John Fleming. Only the top two vote-getters May 16 will proceed to a June 27 runoff.
If he loses, Cassidy’s departure would force a change in Republican leadership for the Senate Health, Education, Labor and Pensions Committee. Cassidy voted to convict the president after his 2021 impeachment, and Trump wants him gone.
Cassidy, with big support from the healthcare and pharmaceutical industries, has more than twice as much campaign cash as Trump’s pick, Letlow. The MAHA PAC had pledged in early February to spend $1 million to back her and defeat Cassidy, but has given only a little over one-third of that to Letlow as the race hits the home stretch.
Cassidy for Louisiana Senate spent roughly $4.6 million on ads promoting his record in Congress, leading on health and energy issues, since early March.
If Cassidy is ousted, industry groups will lose an influential ally on Capitol Hill.
The MAHA Factor
The top GOP spot on the Senate HELP committee could go to a more MAHA-aligned leader. Though Republican Sens.
Marshall declined to answer whether he was interested in being a possible HELP leader, saying, “I’m rooting for Senator Cassidy. He’s a real good friend.”
Some of the more recent health policy pushes from the GOP—Trump’s Most Favored Nation drug pricing proposal tying prices to lower ones in other countries, pharmacy benefit manager changes, and cracking down on health insurer and hospital practices—are sure to bubble up again if Republicans retain their Senate majority in the fall. While some GOP senators appear skeptical of the Most Favored Nation policy, Cassidy has said he’s open to the plan.
The nascent MAHA movement focuses on a wide range of health issues—including fighting ultraprocessed foods, pesticides, and vaccine mandates—and is starting to cohere as a political movement as its aims appeal to more voters.
“You can be aligned with the MAHA movement and not identify as either a Republican or a Democrat,” said Debra Sheldon, vice president of the MAHA Institute who also worked to raise money for Kennedy’s 2024 presidential campaign. “It kind of transcends those political identities.”
Letlow said in an interview that she was “so proud” of her MAHA PAC endorsement.
“As a concerned mom, I support millions of concerned other moms and dads across this country who want healthy options for our children,” said Letlow, who recently introduced a bill that would enshrine into law new dietary guidelines issued by Kennedy and Agriculture Secretary Brooke Rollins.
Some Democrats have rushed to endorse aspects of the MAHA movement, particularly on healthy foods and opposing pesticides.
But MAHA has little experience with politics, since the movement largely sprung up in response to Covid-19 vaccine mandates and around Kennedy’s presidential bid.
The MAHA PAC holds weekly calls with supporters. Letlow, Paul, and Rep.
MAHA’s Appeal
Even if MAHA’s chosen candidate doesn’t win, it has left a lasting impression on how the candidates approach healthcare.
Fleming is promoting himself as a proponent of “health freedom,” and opposes vaccine mandates—a similar approach to the Republican Party more broadly.
“I’m more aligned on MAHA than Letlow is,” Fleming said in an interview, referring to Letlow’s support for the Covid vaccine. “I don’t think there’s nothing in her positions and nothing in her background that would make her a MAHA candidate other than the fact that she is endorsed by President Trump.”
Cassidy has been promoting his own health agenda that includes expanding access to safe and nutritious food and tackling chronic disease.
“Healthcare has obviously been an issue near and dear to the senator’s heart. It’s something that we have talked about constantly on the stump,” Cassidy campaign adviser Mark Harris said on a recent call with reporters. “I think it’ll be one of the reasons we get to the other side in a difficult election.”
His campaign has sunk about $167,000 into a healthcare affordability ad that touts Cassidy’s legislation banning surprise medical bills.
“I’m going to do my darndest and work with the president,” Cassidy said on April 30, in the hours after Trump withdrew Means’ surgeon general nomination. “The people in Louisiana are going to vote for someone who’s delivered for Louisiana. And I can look at the things that I have delivered for the state of Louisiana. And it is far more than any of my opponents.”