2026-03-15T11:00:35.212Z / CNN
2025年2月，路易斯安那州参议员比尔·卡西迪（Bill Cassidy）在长达数十年的医学职业生涯与政治风险间权衡，最终投下关键一票，确认知名疫苗质疑者小罗伯特·F·肯尼迪（Robert F. Kennedy Jr.）担任总统内阁的卫生与公众服务部部长。
但这一选择并未确保参议员的政治前途。如今，这位以倡导疫苗接种为职业的现任议员陷入家乡激烈的初选混战——且未获得唐纳德·特朗普总统的支持。在为政治生命而战时，他必须决定是否确认肯尼迪盟友凯西·米恩斯（Casey Means）担任特朗普的卫生部长。
尽管面临阻力，是否安排投票推进米恩斯提名的争论再次将卡西迪推到风口浪尖。他正面临与众议员朱莉娅·莱特洛（Julia Letlow）和州财政部长约翰·弗莱明（John Fleming）的三方初选对决：莱特洛获得总统背书，并被”让美国重获健康”（Make America Healthy Again，简称MAHA）运动拥护；弗莱明则试图在竞选中树立保守派形象。
知情人士透露，米恩斯的提名似乎并未朝着有利方向发展，这或许与卡西迪的投票立场无关。
卡西迪所在的健康、教育、劳工与养老金委员会成员、阿拉斯加州参议员莉萨·穆尔科斯基（Lisa Murkowski）上周告诉CNN，被问及是否支持米恩斯时，她”并不热衷”。缅因州共和党参议员苏珊·柯林斯（Susan Collins）也正面临艰难的连任竞选，她周四对CNN表示仍在审核米恩斯提交的书面问题。
如果民主党人统一反对，委员会中哪怕仅失去一张共和党的支持票，米恩斯的提名都可能夭折。作为委员会主席且已是总统重点打击目标，这对卡西迪而言只是又一个政治难题。
“卡西迪的最佳选择是让她撤回提名，”路易斯安那州立大学政治学教授罗伯特·霍根（Robert Hogan）表示，”无论支持还是反对，他都难以从中获益。他已用尽其他策略，却未能打动选民。”
CNN已联系参议员办公室寻求置评。
本月早些时候，卡西迪在接受CNN采访时拒绝评论米恩斯是否明确疫苗立场，或自己是否准备支持她的提名。”我还没准备好评论昨天的听证会，”他说。
他尚未安排委员会对米恩斯提名的投票。
过去一年，卡西迪竭力讨好总统及其选民。他在11月还公开表示相信总统会在竞选中保持中立，直到特朗普最终支持莱特洛。
卡西迪是总统优先事项”拯救美国法案”（SAVE America Act）的坚定支持者，该法案对美国选民实施严格的身份证和公民身份证明要求。过去一年，他对特朗普所有内阁提名人都投了”赞成”票，在被追问是否后悔对小RFK的投票时也谨慎应对。
“生活是向前看的。我必须尽力让美国民众放心，疫苗是安全的，总统也相信疫苗，”卡西迪去年11月对Punchbowl新闻表示。
路易斯安那州已从全员初选改为传统党派提名制，选民必须登记为共和党人或无党派才能投票。这使得卡西迪争取特朗普支持者的任务更加关键。5月16日的初选若无人获得50%选票，将进入6月决选。
卡西迪职业生涯作为医生为路易斯安那人接种疫苗，在委员会投下关键票通过了肯尼迪的提名，而肯尼迪后来改变了儿童疫苗的长期既定建议。但现在他是否会支持米恩斯，仍是未知数。
米恩斯的确认听证会充满争议，卡西迪追问其疫苗效力观点，让部分共和党参议员质疑她的任职资格。
“我想强调，这不是我要复杂化或带疫苗议程的问题，这不是我的核心关切，”米恩斯上月对卡西迪表示。
听证会结束后，卡西迪告诉CNN，他对疫苗的总体看法是”不确定信息对救命措施而言存在后果”。
MAHA攻击线
卡西迪对米恩斯的支持犹豫和提名安排的拖延，已成为莱特洛的关键攻击点。莱特洛与路易斯安那州的MAHA运动紧密结盟，并获得MAHA核心政治行动委员会的支持。
“卡西迪参议员主持监督米恩斯提名的委员会，却拒绝表明对特朗普提名人的立场。路易斯安那需要一位支持总统、推动其提名通过的参议员，”莱特洛在声明中表示，”反对米恩斯就是反对让美国重获健康。”
莱特洛本月任命疫苗质疑者、肯尼迪盟友、前路易斯安那州卫生部长拉尔夫·亚伯拉罕（Ralph Abraham）为竞选主席。
尽管米恩斯提名问题在华盛顿备受关注，共和党候选人之一的弗莱明告诉CNN电话采访，家乡竞选中该问题尚未成为主要议题。
“这确实是一场运动，但说实话，我没有看到相关民调显示其影响规模。社交媒体上有不少讨论，但候选人之间的辩论和广告中几乎没提及MAHA，”弗莱明说。
然而，MAHA运动承诺将影响包括卡西迪在内的多个中期选举。该运动每周召开集会，定期宣称能成为中期选举的决定性力量。随着米恩斯提名悬而未决，MAHA行动主席托尼·莱昂斯（Tony Lyons）及其他领袖正敦促选民向穆尔科斯基和柯林斯施压。
“建制派称她太激进，右翼某些人说她不够激进，”肯尼迪任命的疫苗顾问、MAHA每周集会常客罗伯特·马龙（Robert Malone）上周在集会上表示，”这正是难以被任何派系操控的典型，这正是当前所需。”
对卡西迪而言，即便强行推动米恩斯提名通过或公开支持，对他的政治帮助可能也有限。2021年1月6日国会山骚乱后，他投票弹劾总统，后来甚至暗示应该放弃连任，已失去特朗普的支持。
“卡西迪正打出所有旗号，发出任何信号希望得到原谅，因为他犯下了得罪总统的致命错误，”霍根教授表示，”但目前来看，这已无关紧要。”
CNN记者艾莉森·梅因（Alison Main）对此报道有贡献。
Bill Cassidy faces another MAHA fight with his reelection on the line
2026-03-15T11:00:35.212Z / CNN
Louisiana Sen. Bill Cassidy in February 2025 weighed possible political peril against a long career in medicine, ultimately casting the critical vote to confirm known vaccine skeptic Robert F. Kennedy as the president’s Health and Human Services secretary.
But the choice hasn’t guaranteed the senator’s political future. Now the incumbent who made a career out of advocating for vaccines is ensnared in a bitter primary election back home — without President Donald Trump’s support. And as he fights for his political life, he must decide whether to confirm a Kennedy ally, Casey Means, to serve as Trump’s surgeon general.
The saga of whether to schedule the vote and push for Means’ nomination despite headwinds is putting Cassidy back in the spotlight as he faces off in a three-way primary against Rep. Julia Letlow, who has been endorsed by the president and embraced by the “Make America Healthy Again” movement, and John Fleming, a state treasurer who has tried to establish himself as a conservative alternative in the race.
Sources close to the process concede that Means’ nomination doesn’t appear to be trending in the right direction and that may be regardless of how Cassidy casts his vote.
Alaska Sen. Lisa Murkowski, a member of Cassidy’s Health, Education, Labor and Pensions Committee, told CNN last week that she’s “not enthusiastic about her” when asked whether she would support Means. And Sen. Susan Collins, a Republican from Maine who is locked in a tough reelection fight of her own, told CNN on Thursday that she was still reviewing written questions Means had submitted.
The loss of just a single GOP vote in the committee could kill Means’ nomination if Democrats are unified against her. And as the chairman of the committee and already a top target of the president’s, it’s just the latest headache for Cassidy.
“The best-case scenario for Cassidy is that she withdraws,” said Robert Hogan, a professor of political science at Louisiana State University. “I don’t think he has much to gain by opposing it or championing it. He has used all his other signals and it hasn’t moved people.”
CNN has reached out to the senator’s office for comment.
In an interview with CNN earlier this month, Cassidy declined to comment on whether Means had been clear enough about her position on vaccines or if he was prepared to back her nomination. “I’m not prepared yet to comment on the hearing yesterday,” he said.
He has not scheduled a committee vote on her nomination.
For the last year, Cassidy has gone out of his way to try to ingratiate himself with the president and his voters. Cassidy said publicly as recently as November that he believed the president was going to stay neutral in the race before Trump ultimately endorsed Letlow.
Cassidy has been a fierce supporter of the president’s top priority, the “SAVE America Act,” a bill that imposes strict voter ID and proof-of-citizenship requirements for US voters. In the last year, he has voted “yes” on all of Trump’s Cabinet nominees and he has been careful when pressed on whether he regrets his vote on RFK Jr.
“Life is lived forward. What I have to do is do my best to reassure the American people that vaccines are safe, that the president believes in vaccines,” Cassidy told Punchbowl News last November.
Cassidy’s task to win over Trump voters has become more essential now that Louisiana has moved from an all-party primary to a more traditional partisan nominating system where voters must be either registered Republican or no party to cast ballots. The primary is scheduled for May 16 and if no candidate gets 50% of the vote, the race will be forced to a June runoff.
Cassidy, who spent his career as a doctor helping vaccinate Louisianans, cast the determining vote in committee to approve Kennedy, who went on to change long-established recommendations for childhood vaccines. But whether Cassidy will now double down and back Means is another question.
Means underwent a tumultuous confirmation hearing that saw Cassidy press on her vaccine efficacy views and left some GOP senators with questions about her fitness for the post.
“I wanted to back up and broadly just reassure you that this is not an issue that I intend to complicate, or bring an agenda on vaccines. This is not the core of my issue,” Means told Cassidy last month.
Following the hearing, Cassidy told CNN that overall his view of vaccines is “there are consequences of having an uncertain message on something which is life-saving.”
A MAHA attack line
Cassidy’s reluctance to come out in support for Means and schedule the vote for her confirmation has become a key attack from Letlow, who has aligned herself closely with the MAHA movement in the state and has earned the backing of the chief political action committee aligned with MAHA.
“Senator Cassidy chairs the committee overseeing her nomination, yet he refuses to say where he stands on President Trump’s nominee. Louisiana deserves a senator who stands with President Trump and who helps move his nominees forward,” Letlow said in a statement. “A vote against Casey Means is a vote against Making American Health Again.”
Letlow has brought on vaccine skeptic and Kennedy ally, former Louisiana surgeon general Ralph Abraham to be her campaign chair this month.
While the issue of Means’ nomination may be top of mind in Washington, Fleming, the other GOP candidate in the race, told CNN in a phone interview that the issue isn’t yet playing a major role in the campaign back home.
“It is definitely a movement. I have not seen any polling to see how big of an impact it has, to be honest with you. You see a fair amount on social media discussions and so forth. But to be honest with you in terms of discussions between candidates and in ads, you don’t really see anything mentioned about MAHA,” Fleming told CNN.
Still, Cassidy’s is one of several midterm races that the MAHA movement has promised to sway.
MAHA Action, which holds weekly rallying calls for its supporters, has regularly promised that the movement can be the decisive votes in midterms races. And with the Means vote hanging in the balance, MAHA Action president Tony Lyons and other MAHA leaders are urging voters to press Murkowski and Collins.
“The establishment says she’s too radical. Elements of the right say she’s not radical enough,” Robert Malone, a Kennedy-appointed vaccine adviser and frequent speaker on the weekly MAHA Action meetings, said during a call last week. “That’s the signature of someone who cannot be captured by any faction. That is exactly what this moment calls for.”
For Cassidy, the Means nomination may be a blip on the political radar that does little to help him even if he muscled it through or came out in support of her. He already lost Trump’s endorsement after he voted to impeach the president over the January 6, 2021, Capitol attack and later suggested he should drop his reelection bid.
“Cassidy is flying all the flags and sending any signals he can in hopes he can be forgiven for committing the cardinal sin and crossing the president,” Hogan, the LSU professor, said. “At this point, I don’t think it is going to matter very much.”
CNN’s Alison Main contributed to this report.
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