On Monday night, just hours ahead of a Senate committee vote Tuesday on Robert F. Kennedy Jr.’s nomination as health secretary, Sen. Bill Cassidy was still deciding what to do.
Cassidy, who worked 30 years in public hospitals in Louisiana, is a lifelong advocate of vaccinations. After watching a young woman almost die of liver failure after contracting hepatitis B, the doctor helped to create a program offering free shots to school children.
Kennedy, on the other hand, had built a large following on social media by questioning the safety of vaccines and falsely linking them to autism, despite numerous large studies debunking the myth.
Now, Cassidy was the sole GOP senator on the Senate Finance Committee openly questioning whether Kennedy was the right man for the job. A single “no” vote by any Republican on the panel could have been enough to derail the nomination by President Donald Trump, who said he picked Kennedy to “go wild” on issues related to food, medicine and health.
Cassidy said he was asking: “Would it be possible to have Mr. Kennedy collaborate in helping public health agencies re-earn the trust of the American people?”
The Louisiana Republican said he received “hundreds” of personal messages a day and “thousands” more through his Senate office. Worried pediatricians urged Cassidy to block Kennedy from the job, blaming Kennedy for a rise in vaccine hesitancy among parents. There were pro-Kennedy social media influencers too, including “MAHA moms” – a reference to Kennedy’s call to “Make America Healthy Again” — demanding that he be given a chance to shake up what they saw as a broken system.
“It was a massive coalition that worked together to bring together several different groups that were literally shutting down the phone lines over the weekend and late last week and yesterday,” Vani Hari, a food influencer nicknamed the “Food Babe” on social media, told ABC News.
“The messaging was very positive,” she said.
According to one person familiar with Cassidy’s thinking, the senator was 95%” of the way to a “yes” vote on Monday night, but that the issue of vaccines stood in the way.
In particular, Cassidy was worried about a potential measles outbreak if Kennedy were to assume control of America’s health agencies and continue to raise doubt about the vaccine, which had been used for decades to prevent the highly contagious and potentially deadly childhood disease.
“He needed something to just let him feel comfortable enough that he wouldn’t be responsible for the death of children because of this,” the person told ABC News of Cassidy’s concerns.
A lifelong Republican, Cassidy had already defied President Donald Trump once by voting in 2021 in favor of a single article of impeachment of Trump in connection to the Jan. 6 attack on the Capitol and faces a Republican primary challenger for his Senate seat next year.
By Tuesday, Cassidy appeared to have gotten what he needed to vote “yes.” After speaking several times with Kennedy by phone throughout the weekend and again the morning of the vote, Cassidy announced on the social media platform X that he had “serious commitments” from both Kennedy and the White House.
Among those promises is that Kennedy will give advanced notice to Congress if he imposes any changes to vaccine safety monitoring and will meet with Cassidy several times a month to build a working relationship.
Both the administration and Kennedy had sought “to reassure me regarding their commitment to protecting the public health benefit of vaccination” and offering an “unprecedentedly close collaborative working relationship,” Cassidy said.
Cassidy’s support paves the way for a full vote by the Senate.
“It’s been a long, intense process, but I assessed it as I would assess a patient as a physician. Ultimately, restoring trust in our public health institution is too important, and I think Mr. Kennedy can help get that done,” Cassidy said.
How a doctor and lifelong advocate of vaccinations found himself voting for Kennedy is an indication of Trump’s grip on the Republican party, experts say. And while Cassidy might believe he can keep Kennedy in check, there’s not much motivation for the new administration to keep promises to individual lawmakers.
“It’s a totally different kind of Washington,” said Sarah Isgur, a Republican who served in the first Trump administration and is now an ABC News contributor.
Whereas in the past, lawmakers and members of the executive branch worked closely together to build the kinds of relationships that might extend long after they leave public service, the current administration says its focus is forcing through big changes, not making friends or future job connections.
“Cassidy is doing something very rational, which was done in past administrations,” said Isgur. “But it’s based on a previous version of Washington … This administration has made clear they are not running the government on relationships.”
In another time, Kennedy’s nomination would have been unthinkable. A Democrat whose cousin Caroline Kennedy told senators was a “predator” who sought only attention and fame, Kennedy is known for promoting debunked conspiracy theories on health. In recent years, he chaired the Children’s Health Defense, a group that advocates against the recommended schedule for children’s vaccines. He also played a central role in preparing a lawsuit against the manufacturer of the HPV vaccine. He has since promised to divest potential proceeds in the case, which is ongoing, to his adult son.
Kennedy counters that he believes the pharmaceutical industry is too focused on profits and that medical experts aren’t doing enough to question commonly held assertions while Americans suffer from chronic diseases.
“News reports have claimed that I’m anti-vaccine or any industry. I am neither. I am pro-safety,” Kennedy told lawmakers last week.
Brad Woodhouse, director of the liberal advocacy group Protect Our Care, said the fight wasn’t over until the full Senate votes.
“Every Senator will now have to weigh in, and we aren’t giving up on any vote,” he said in a statement released shortly after the vote.
Republicans have a 53-seat majority, allowing Kennedy to lose three Republicans and still survive with Vice President JD Vance casting a tie breaking vote if necessary.
GOP Sens. Susan Collins of Maine, Lisa Murkowski of Alaska and Mitch McConnell of Kentucky are widely seen as potential “no” votes because of their willingness to challenge the administration on other issues. McConnell, a polio survivor, has spoken previously about the value of a health secretary who supports medical consensus on vaccines.
Another potential swing vote — Republican Sen. Thom Tillis of North Carolina – already announced he would back Kennedy after receiving assurances that Kennedy wouldn’t intercept the work of the Centers for Disease Control and Prevention or the National Institutes of Health
The Trump administration has already paused major functions at CDC, including blocking the release of the agency’s weekly publication — the Morbidity and Mortality Weekly Report — as part of a pause on all public communications to ensure everything released is in line with Trump’s agenda.
“I for one, think that it is time to put a disruptor in. It is time to put somebody in there that’s going to go wild,” Tillis said.
Democrats said they too want someone to challenge the status quo on chronic disease, but said Kennedy’s denial of scientific consensus wouldn’t help Americans.
“I want a disruptor in the healthcare system and one leading it. I don’t want a destroyer,” said Sen. Peter Welch, D-Vt.
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