Is Bill Cassidy’s Loss a MAHA Win?

By Grayson Logue

Tuesday, May 26, 2026

 

Sen. Bill Cassidy of Louisiana lost his bid for reelection in the Republican primary earlier this month. He came in third behind a Trump-endorsed challenger, Rep. Julia Letlow, and Louisiana State Treasurer John Fleming, who advanced to a June runoff. Political observers have portrayed Cassidy’s defeat as proof of President Donald Trump’s continued grip over the GOP and a cautionary tale of faltering, principled dissent.

 

Cassidy broke with Trump over the January 6 riot, voting for his impeachment during his Senate trial, but the two-term senator also voted to confirm the face of the modern anti-vaccine movement, Robert F. Kennedy Jr., as the Department of Health and Human Services (HHS) secretary. 

 

The president and Make America Healthy Again (MAHA) advocates cheered Cassidy’s defeat, but both parties have now lost whatever political leverage they once held over the senator. Cassidy, a physician who chairs the Senate Health, Education, Labor and Pensions (HELP) Committee, could be a particular headache as the administration tries to fill vacancies in key Senate-confirmed positions at HHS, including Food and Drug Administration (FDA) commissioner, Centers for Disease Control and Prevention (CDC) director, and surgeon general.

 

One way to read Cassidy’s defeat is a sign of MAHA’s electoral power. MAHA Action, an advocacy group, endorsed Letlow, the leading Cassidy challenger, and MAHA PAC donated $580,000 to her campaign, according to recent Federal Election Commission filings. That’s certainly the story that MAHA PAC and MAHA Action leader Tony Lyons want to tell. “This is a powerful indication that MAHA is a gift to the Republican Party,” he said the day after the primary.

 

Another telling is that MAHA, grasping for relevance in the midterm cycle and struggling for funds, rode the coattails of Trump’s effort to sink Cassidy. At the most proximate level, the reason why Cassidy didn’t make it to the runoff is because Louisiana Gov. Jeff Landry pushed through a change to the state’s primaries. Previous primaries had been open to any voters regardless of party affiliation, but only registered Republican voters were eligible to cast ballots in this year’s primary. Unaffiliated moderates and Democrats couldn’t vote for Cassidy unless they changed their registration. Louisiana’s Republican lieutenant governor, who opposed the change, suggested earlier this year that the primary rules were switched with the express goal of ousting Cassidy. MAHA advocates had nothing to do with the change. Fleming, a MAGA Republican that MAHA didn’t endorse, also secured more of the vote than Cassidy.

 

While the White House seems more than happy to pay lip service to MAHA goals while the midterms still loom, Cassidy’s new lame duck status comes at a time when the administration has also pivoted away from vaccine issues and ignored several of the movement’s priorities, including on herbicide use. The question for the movement following Cassidy’s loss is how influential MAHA will be for the administration in 2027 if Democrats secure a wave victory this November. What will the White House’s appetite for iconoclastic HHS leaders and appointees or more vaccine disruptions be after such a loss? In the interim, White House and MAHA will be stuck with Cassidy helming the Senate’s health committee. 

 

Cassidy unbound.

 

Cassidy joked with a reporter last week about possibly being “unbound” since his loss, and he’s wasted little time taking advantage of his newfound freedom. In the 72 hours following his primary loss, Cassidy came out against Trump’s ballroom project and the Justice Department’s recently announced $1.8 billion “anti-weaponization” slush fund. He vocally defended his January 6 impeachment vote, a subject he’d been quiet about for years, and last Tuesday, he joined Democrats and three of his Republican colleagues in advancing a war-powers resolution to end the Iran war unless the president secured congressional authorization for the conflict. 

 

He has also signaled a readiness to push back on Kennedy and HHS policies he disagrees with. “Absolutely, I’ll hold him accountable, not to be destructive, no, but to be constructive,” Cassidy said Monday when asked about oversight of the health secretary. He also emphasized that the administration has “had some bad policies regarding vaccinations.” Cassidy could use his power as chair to put Kennedy back in the hot seat or hold hearings to scrutinize any undue political influence on scientific decision-making, as he did after Kennedy fired CDC Director Susan Monarez last summer.

 

The administration will need Cassidy and the HELP committee’s cooperation to fill a lengthy list of vacancies at HHS, as well as key posts in other departments, including the commissioner of the Bureau of Labor Statistics. Trump falsely claimed that a lackluster jobs report last summer was “rigged” and promptly fired the previous commissioner.

 

Even before the primary, Cassidy had shown some willingness to push back on White House picks for CDC director and surgeon general. The administration has had to withdraw previous HHS nominees after it became clear they wouldn’t make it through the HELP committee, including Dave Weldon for CDC director and, more recently, Casey Means for surgeon general. “If you look at the HELP committee, there’s already been some back and forth regarding nominees,” Cassidy told NOTUS last week. “Am I going to deliberately push back on things? No. I’m going to do what’s good for my country and my state.”

 

Setbacks for MAHA.

 

In April, the president announced Dr. Erica Schwartz, the deputy surgeon general in his first administration, as his new nominee for CDC director and Dr. Nicole Saphier, a radiologist and a frequent Fox Business contributor, for surgeon general. A HELP spokesperson told The Dispatch that the committee is still waiting on paperwork on Schwartz and Saphier from the Office of Government Ethics to begin consideration of their nominations.

 

Sean Kaufman, an infectious disease specialist and biosecurity consultant, was also nominated last month to lead the health department’s public health emergency response agency, which has been without a permanent leader since Trump took office. The White House has yet to name a nominee to replace Marty Makary as FDA commissioner.

 

MAHA activists castigated Cassidy over the failure of the Means nomination, but the movement’s influence on HHS appointments could continue to suffer as a result of Cassidy’s loss. Schwartz and Saphier are much more traditional picks than a figure like Means. The American Public Health Association endorsed Schwartz as qualified for the post.

 

Both Schwartz and Saphier are broadly supportive of vaccines, though Saphier has signaled openness to making changes to the childhood vaccine schedule and opposes vaccine mandates. But she has also vocally defended vaccines as critical tools to prevent illness and infectious disease and criticized the way Kennedy changed federal vaccine guidance.

 

“I did think the original CDC vaccine schedule was somewhat bloated,” Saphier said on her podcast in March. “I thought we could scale back on certain things. Some of the things RFK Jr. has done, you know, I wasn’t staunchly opposed to, but the way that it has been communicated makes it seem that changes are being done because they found new evidence showing it’s not safe or it’s not effective, and that’s just not true.” She also publicly criticized Trump over his claims about the dangers of Tylenol for pregnant women and how the administration is handling a forthcoming assessment about the country’s measles elimination status, suggesting the study was purposefully delayed until after the midterm elections.

 

Of course, any tempering influence Cassidy exerts will end when he leaves the Senate in January, and Sen. Roger Marshall, a Kansas Republican, is reportedly angling to take over the HELP chairmanship if the GOP keeps control of the Senate. Marshall is an OB-GYN and a MAHA ally who disagreed with Cassidy on vaccines, particularly over whether the hepatitis B vaccine should be given at birth. He’s also been a Kennedy defender, saying during the secretary’s nomination hearing, “I think that you are the person to lead HHS to make America healthy again, that God has a divine purpose for you.” 

 

But the senate-confirmed HHS vacancies will more than likely be filled by then, and MAHA’s influence over the administration’s health policy and personnel appears on a downward trajectory. The administration is continuing to replace HHS appointees allied with Kennedy and backed by MAHA. Earlier this month, the administration fired Tracy Beth Høeg, the FDA’s top drug regulator and the co-author of a report justifying Kennedy’s overhaul of the childhood vaccine schedule earlier this year.