Trump impeachment and RFK Jr. votes loom as Sen. Bill Cassidy fights for political survival

COVINGTON, La. — Sen. Bill Cassidy knows Republican voters won’t forget his decision to convict President Donald Trump in the Jan. 6 impeachment trial. But Cassidy’s re-election to another term in Louisiana this year could depend on whether they are willing to pardon him.

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At a recent campaign stop at an assisted living facility in Louisiana’s Northshore, the first question asked by the crowd was whether Cassidy regretted his impeachment vote, as well as his vote to confirm Health and Human Services Secretary Robert F. Kennedy Jr.

Cassidy acknowledged that “those will be two votes that people remember me for.” But he also defended himself, saying he made his choices based on the best available information he had at the time. And he added that “no,” he doesn’t think Trump should “continue” to be impeached.

Asked later by NBC News if he thought his impeachment vote would be a liability in his Republican primary, Cassidy said it “could be.” But he also sought to downplay his rift with Trump as a temporary disagreement, pointing out that he voted with the president 90% of the time.

“I tell people, ‘Hey, are you married? Has your spouse ever done something you didn’t really like?’ And you do,” he told NBC News in an interview broadcast on “Meet the Press NOW.” “I focus on the present and the future. If you want someone to take care of our state, make Louisiana a place where people settle down to put down roots, raise their children and grandchildren, I’m your guy.”

Cassidy, a doctor who has served in Congress for 17 years, is in the fight for his political life as he fends off a primary challenge from Trump-backed Rep. Julia Letlow and Louisiana Treasurer John Fleming in deep-red Louisiana. More than $20 million was spent on the airwaves ahead of the May 16 primary, according to tracking company AdImpact.

Cassidy has the support of Senate Republican leaders and the benefit of an experienced and prolific fundraising operation. But both Letlow and Fleming attempted to portray Cassidy as anti-Trump, while the president himself recorded videos supporting Letlow.

But those aren’t the only headwinds Cassidy faces. As chairman of the Senate Health, Education, Labor and Pensions Committee, he also clashed with the “Make America Healthy Again” movement because of his unwavering support for vaccines.

And although he was the deciding vote in securing the confirmation of Kennedy, a longtime anti-vaccine activist, Cassidy has since repeatedly criticized his actions at HHS — including firing all 17 members of the Centers for Disease Control’s Advisory Committee on Immunization Practices and replacing them with members of his choosing, including several known vaccine skeptics. Those tensions could be on full display again when Kennedy testifies publicly before the panel later this month, forcing Cassidy to walk a delicate tightrope.

Cassidy’s refusal and his initial hesitation to support Kennedy did not go unnoticed within the MAHA movement that the secretary champions. Kennedy ally Tony Lyons supports Letlow and pledged $1 million through his “Make America Healthy Again PAC” to help defeat Cassidy before Letlow even entered the race. (So ​​far, the group has spent more than $200,000 supporting Letlow.)

Cassidy largely downplayed his differences with the MAHA movement, highlighting some of the areas in which they are aligned. But he also argued that, on the topic of vaccines, more voters might be on his side now that people have seen the deadly consequences of not getting vaccinated.

“MAHA and I are totally united on ultra-processed foods, and we’ve had a lot of success there,” he told NBC News. “Obviously I have differences with some on vaccination, but I think when we see thousands of people getting measles in these outbreaks and children dying from measles and other vaccine-preventable diseases, people are sort of open to that. They understand that it’s important.”

Cassidy, 68, who kicked off the recent election campaign by talking about his career in medicine and saying “being a doctor defines who I am,” has tried to build on his health care credentials in other ways.

He told NBC News that he recently spoke with Trump’s team about developing a bill to lower the cost of health care, which he hopes to implement “soon.” He spearheaded a separate health care proposal introduced by Senate Republicans in December that failed to gain the bipartisan support needed for passage.

Heading into this fall’s midterm elections, Republicans are still trying to find their footing on the topic of affordability, which will likely be a defining issue in a number of key races.

“Voters are very concerned about economic issues. We need to talk about affordability. It’s likely that the price of gas will continue to be influenced by the war in Iran,” Cassidy told NBC News. “When I started talking about health care affordability, heads nodded, and when I talked about trying to reduce the cost of prescription drugs, heads nodded in agreement that this is what we need to do.”

The three candidates in Louisiana’s Republican Senate primary could face another obstacle: Trump’s crusade against mail-in voting. Last week, the president signed an executive order aimed at restricting the practice, although it faces legal challenges.

That led some Republican voters to question whether mail-in ballots could be used safely, which could be a major problem in Louisiana’s primary since it takes place on a Saturday. During his campaign stop, town hall-style, someone in the crowd expressed concerns to Cassidy about mail-in voting, noting that Trump had described it as a “way to cheat.”

Cassidy assured the room that mail-in ballots are safe to use in Louisiana.

“I like mail-in voting,” he said, before turning to his support for the SAVE America Act, a Trump priority that aims to impose national voter ID requirements and require proof of citizenship to register to vote.

Speaking to NBC News, Cassidy wouldn’t say whether he thought Trump’s rhetoric on mail-in voting was helpful. But he continued to defend mail-in voting in red states like Louisiana, while giving oxygen to Trump’s unfounded claims that the practice can be ripe for fraud in Democratic-led states.

“As a doctor, I know there are people who can’t physically get to a voting booth, and you want to make sure they can still vote,” he said. “But I will proudly say about my state that people don’t talk about corruption in elections in my state.”

Between newly instituted rules that only allow registered Republicans to participate in GOP primaries and the prospect of lower turnout for Saturday’s election, hardline conservatives could play an outsized role in the outcome. And Letlow and Fleming think that could bode well for their own prospects.

Letlow, 44, who filled her husband’s congressional seat after he died of Covid-19 days after winning his race, was heavily recruited by the Trump administration to run for Cassidy’s seat and entered the race earlier this year after the president endorsed her on social media.

“That support has been a huge source of energy for our campaign, because Louisiana Republicans trust President Trump,” Letlow told NBC News in an interview.

“When the president tells you we need to act, and when the voters of Louisiana are really encouraging, saying we want an alternative, we want another choice, would you consider doing that? Would you pray about it? And you know, when I got this article about it, I decided to go all in on it,” Letlow added.

But Letlow faces his own challenges. Cassidy criticized her for her past support of diversity, equity, and inclusion (DEI) policies when she was a university faculty member, for her late disclosure of personal stock transactions, and for the fact that none of her bills were signed into law. Letlow defended its stock trading business, emphasizing that its investments are professionally managed by an independent third party and that the administrative error was corrected as soon as it was discovered. She also said she changed course on DEI after “seeing it for what it was” and spending her time in Congress “fighting against it.”

“Cassidy is lying about me because he can’t make his own case,” she said.

If no candidate manages to obtain a majority of votes on primary day, the top two vote-getters will advance to a runoff on June 27. Fleming, a former congressman, thinks he can take out Letlow and face Cassidy one-on-one.

Fleming, who served in various positions in the first Trump administration and was a founding member of the conservative House Freedom Caucus, said he was the candidate with the most MAGA credentials.

But Fleming’s candidacy has created headaches for Trump’s allies because it could prolong the race.

Fleming told NBC News in an interview that in late January, around the filing deadline, someone “around” the Trump administration offered him a job dropping out of the race to help pave the way for Letlow, but he declined to accept it. Fleming declined to say who made the opening or what the work would have been.

“They were trying to get me to make it easier for him,” Fleming said. “And along the way, President Trump and I had a brief conversation, and it was a very, very good conversation. And as far as I know, we’re on very good terms.”

The White House did not immediately respond to a request for comment.

Fleming warned that Letlow was becoming “overconfident” that Trump’s endorsement would secure her support from the MAGA base.

“While support like that is certainly popular and helpful, particularly in Louisiana, … it does not get you elected,” he said.