US Senator Bill Cassidy, R-Louisiana, attends a business meeting of the US Senate Finance Committee to consider the nomination of Robert F. Kennedy, Jr. for Secretary of Health and Human Services, on Capitol Hill in Washington, DC, February 4, 2025. in his confirmation bid on Tuesday, as senators voted for his nomination on the floor. (Photo by SAUL LOEB/AFP) (Photo by SAUL LOEB/AFP via Getty Images)
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Last week, Sen. Bill Cassidy (R-Louisiana) lost his Republican primary in his bid to serve a third term in the US Senate.
The defeat has political consequences for Cassidy. But it also contains a larger lesson about leadership, public health, and political risk.
In early 2025, Cassidy, a physician and senator, publicly wrestled with whether to support Robert F. Kennedy Jr.’s nomination to lead the Department of Health and Human Services. He knew that his vote might be enough to deny Kennedy the nomination. He raised concerns about Kennedy’s long history of fueling vaccine skepticism and spreading misleading interpretations of medical data.
As a doctor, he understood the stakes better than most members of Congress. But in the end, Cassidy voted to confirm him.
The decision appeared rooted in political survival — an effort to avoid backlash from a Republican base increasingly aligned with Trump and the emerging Make America Healthy Again movement surrounding Kennedy.
It didn’t work.
Cassidy will now finish his last term in the Senate as a cripple, while Kennedy will continue to lead the nation’s most important health care agency.
How it could have changed history
Most defining moments don’t feel historic right now. They unfold quietly — in hearing rooms, private conversations, prepared remarks and votes cast under fluorescent lights.
Cassidy could have had such a moment during his confirmation hearings. And he missed it.
He wasn’t just another senator evaluating a controversial candidate—he was uniquely placed to understand the stakes. Before entering politics, he had worked as a doctor in a public hospital for the uninsured for 30 years. He understood science, vaccines, infectious diseases, and the fragile relationship between public trust and public health.
In his own statement In announcing that he would support Kennedy’s confirmation, he emphasized the proven safety of vaccines, saying “the science is good, the science is reliable. Vaccines save lives. They are safe. They do not cause autism. There are many studies that show that. They are a critical part of our country’s public health response.”
I had the opportunity to work briefly with Senator Cassidy when he participated in a focus group sponsored by the de Beaumont Foundation designed to develop messages to encourage more Americans to get vaccinated against COVID-19. It was clear to all that he approached the debate as a doctor first and a politician second. He spoke with the clarity and seriousness of someone who understood both the science and the responsibility of public trust.
If he had voted no — and he explained why as a doctor — the country would have seen something increasingly rare in American public life: a leader who took political risks in defense of science, medicine and the public’s health.
A vote that legitimized false narratives
Cassidy could stand before the nation and declare that his responsibility as a doctor was greater than his responsibility as a senator and that some positions are too important to be politicized.
Instead, it gave dangerous public health positions something far more valuable than a vote in the Senate: institutional legitimacy.
At the time of the confirmation hearings, public confidence in science and medicine was already stretched after the COVID-19 pandemic. The rise of numbers and movements built around skepticism about vaccines, institutions, and public health expertise further normalized mistrust just when the country needed serious leadership and credible public health communication.
Weak public health threatens national security
The United States is once again facing infectious disease threats that warrant national attention. Cases of measles they rekindle. Bird flu continues to cause concern among global health officials. Recent hantavirus outbreaks and outbreaks of plague they serve as a reminder that ancient pathogens never fully disappear. Ebola outbreaks abroad continue to threaten global stability in an interconnected world.
Americans understandably focus on wars, borders and geopolitical conflicts. But history reminds us time and time again that germs can destabilize societies as effectively as missiles.
Public health is national security, public safety and economic prosperity. When we weaken public health, we weaken the nation itself.
A weakened public health system is a threat to workforce productivity, educational continuity, military readiness, economic stability, and public confidence. And yet, as the nation moves deeper into another election cycle, health preparedness and public health leadership remain secondary issues in too many political conversations.
This has to change.
We are already seeing signs that voters understand this reality even if political institutions are lagging behind. Public health issues have moved to the center of citizens’ lives. At Los Angeles mayoral racehomelessness, addiction, mental health and public safety have dominated the conversation. These are public health issues with profound implications for communities and economies.
Putting Public Health in the foreground
Public health no longer operates quietly in the background of American life. It is at the heart of whether communities feel safe, stable and functional.
Increasingly, candidates who can speak credibly about health, addiction, homelessness, mental illness, preparedness and community well-being speak directly to the lived experiences of voters. Candidates who fail to articulate serious public health strategies increasingly risk appearing out of touch with voters’ everyday realities.
Candidates who can offer serious, evidence-based plans to address these and other issues may ultimately have a political advantage over those who remain mired in yesterday’s talking points.
And yet debate moderators spend relatively little time on public health preparedness. Every candidate for great office should have basic questions about health, science and preparedness:
- What is your plan to restore trust in public health institutions?
- How will your administration prepare for future infectious disease threats?
- How will you strengthen the public health workforce?
- What metrics will you use to determine whether Americans are getting healthier?
- What role should science play in policymaking?
Cassidy’s impeachment should serve as a cautionary tale for candidates and elected officials. The country needs leaders who are willing to openly defend science, expertise and public health — especially when doing so involves political risk.
