United States Senator Bill Cassidy (R-LA) is trying to rewrite his history, as his 2026 run for reelection depends upon it. In that, he has a problem: The MAGA base in Louisiana has not forgotten that Cassidy voted to impeach President Donald Trump 45 in 2021, and refused to endorse Trump for his 2024 presidential run. President Donald Trump 47 has also not forgotten, even though Cassidy has been doing his utmost to get back into his good graces, without much success.
As opposed to Cassidy's 2020 run, where a weak Republican candidate, a bunch of no-name Democrats, a couple of Independents, and a Libertarian split the opposition vote, in 2026, Cassidy has lots of rock-ribbed Republican competition. Even with Democrats in this race, there is little likelihood that any vote-splitting will occur. As one political watcher surmised, the last time a Democrat won a Senate election in Louisiana was Mary Landrieu in 2008. Eighteen years is a long stretch, and Louisiana has only grown redder and more pro-Trump. The big upset is that one of those Senate competitors has already garnered President Donald Trump's endorsement — and she hasn't entered the running — yet.
Highly Respected America First Congresswoman, Julia Letlow, of the wonderful State of Louisiana, is a Great Star, has been from the very beginning, and only gets better! I am hearing that Julia is considering launching her Campaign for the United States Senate in Louisiana, a place I love and WON BIG, six times, including Primaries, in 2016, 2020, and 2024!
I know Julia well, have seen her tested at the highest and most difficult levels, and she is a TOTAL WINNER! A Proud Mother of two children, Julia is a wonderful person, has ALWAYS delivered for Louisiana, and would continue doing so in the United States Senate. As your next Senator, Julia will work tirelessly to Grow our Economy, Cut Taxes and Regulations, Support our Amazing Farmers and Fishermen, Champion Louisiana Oil & Gas, Unleash American Energy DOMINANCE, Promote MADE IN THE U.S.A., Keep our Border SECURE, Stop Migrant Crime, Ensure LAW AND ORDER, Strengthen our Military/Veterans, and Protect our always under siege Second Amendment.
Should she decide to enter this Race, Julia Letlow has my Complete and Total Endorsement. RUN, JULIA, RUN!!!PRESIDENT DONALD J. TRUMP
The other well-known Louisiana Republicans who have officially entered the U.S. Senate race are State Treasurer and former Congressman John Fleming; State Senator Blake Miguez, LA Public Service Commission member Eric Skrmetta; State Representative Julie Emerson; and St. Tammany Parish Councilwoman Kathy Seiden. However, it is Rep. Julia B. Letlow (LA-05) who received the presidential blessing.
I’m honored to have President Trump’s endorsement and trust. My mission is clear: to ensure the nation our children inherit is safer and stronger. ⁰
— Julia B Letlow, Ph.D. (@jbletlow) January 18, 2026
This United States Senate seat belongs to the people of Louisiana, because we deserve conservative leadership that will not waver. pic.twitter.com/851hQkXhIN
Whether Trump's endorsement moves the needle for Letlow or not remains to be seen. What is clear is that Trump has washed his hands of Cassidy. According to other reporting, Senate Majority Leader John Thune (R-SD) attempted in a Friday phone call to convince Trump to endorse Cassidy, to no avail. Thune rallied this week for Cassidy in the Pelican State, being both a good majority leader and colleague. But no matter how the competition plays out, it's pretty clear that Cassidy may be toast. If so, he has only himself to blame.
If Rep Julia Letlow does challenge Bill Cassidy, the latter will be in real trouble.
— Nassau Centrist Mapper (@LIEngProf) January 18, 2026
What Rs don’t have to worry about is a D posing a serious challenge. The last D to win a Senate election in LA? Mary Landrieu in the ‘08 wave. Her ‘14 reelection campaign didn’t go as well… https://t.co/qLObVZhkMD pic.twitter.com/CDcpjHzwRR
Always a "flexible" senator, cut from the same cloth as Sen. Lisa Murkowski (R-AK) and Susan Collins (R-ME), our Senior Editor and Louisianan Joe Cunningham surmised that Cassidy badly miscalculated his constituents' allegiance to the president. For his reelection run in 2020, Cassidy positioned himself as pro-MAGA and pro-Trump, then, after he won reelection, promptly flipped. According to him, it was the J6 kerfuffle that had him squawking InSURReXTiON! with the rest of the Democrat loons and choosing to vote to impeach Trump post-presidency.
Big mistake. YUGE.
U.S. Senator Bill Cassidy last ran for re-election in 2020, down the ballot from then-President Donald Trump. He ran as a pro-Trump, MAGA-aligned candidate, drawing on Louisiana Republicans’ motivation to get Trump re-elected in order to stay in office. He won.
Then, January 6, 2021, happened, and Cassidy made a choice that continues to haunt him today: He voted to convict Trump in his post-term impeachment.
The reaction from Louisiana conservatives was swift. Statewide-syndicated radio host Moon Griffon declared that “Bill Cassidy just knifed us all in the back!”
“Bill Cassidy is one of the most arrogant rear ends that I have ever seen in my life,” he added during his monologue on February 10, 2021.
Scott McKay, who publishes The Hayride, a Louisiana-based political commentary site, was similarly harsh.
“[T]his is a career-ending mistake on his part and there is zero point in Bill Cassidy running for re-election,” McKay wrote. “In fact, he would do well to resign his seat as soon as there is a Republican governor in Louisiana available to replace him.”
The Louisiana GOP voted to censure Cassidy. Republicans across the state condemned him. Fast forward five years, and the Louisiana doctor-turned-politician is facing a myriad of challengers for his seat—almost all of them Republicans.
It's not just MAGA Republicans, but MAHA ones. The revolution has grown even more in prominence and popularity since Robert F. Kennedy Jr. was confirmed as Health and Human Services Secretary. A Trump nomination that Cassidy opposed and resisted until the very end. OG (Old Gangsta) MAHA has never forgotten nor will they forget that, as Chairman of the Senate Health, Labor, and Pensions (HELP) committee, it was Cassidy who championed and pushed through the nomination of former CDC Director Susan Monarez. After Monarez was confirmed, she decided her job was to derail the MAHA agenda, and Kennedy rightly fired her after only 29 days on the job. Monarez ran straight to Cassidy, who, along with ranking member Sen. Bernie Sanders (I-VT), demanded HHS Secretary Kennedy sit before the HELP committee to be excoriated for doing his job.
Dive Deeper: The Senate Is Out for Robert Kennedy Over Monarez Firing, CDC Resignations
The Monarez Senate Testimony and the Ploy to Derail Changes to the Childhood Vaccine Schedule
This went nowhere, as the hearing exposed Monarez as the duplicitous shill that she is. In that, Monarez and Cassidy make great bedfellows.
Cassidy still does all he can to undermine Secretary Kennedy and to co-opt the MAHA agenda toward his own ends. He too often drapes himself in his white doctor's coat to tout his superior knowledge and experience, taking not-so-subtle potshots at Secretary Kennedy and his MAHA loyalists, like consultant Calley Means.
As a doctor who treated patients for decades, my top priority is protecting children and families. Multiple children have died or were hospitalized from measles, and South Carolina continues to face a growing outbreak. Two children have died in my state from whooping cough. All…
— U.S. Senator Bill Cassidy, M.D. (@SenBillCassidy) January 5, 2026
As a doctor who treated patients for decades, my top priority is protecting children and families. Multiple children have died or were hospitalized from measles, and South Carolina continues to face a growing outbreak. Two children have died in my state from whooping cough. All of this was preventable with safe and effective vaccines.
The vaccine schedule IS NOT A MANDATE. It’s a recommendation giving parents the power. Changing the pediatric vaccine schedule based on no scientific input on safety risks and little transparency will cause unnecessary fear for patients and doctors, and will make America sicker.
It is well known that Big Pharma funds Cassidy's campaign and therefore controls his votes. Cunningham wrote last year about his work to undercut 340B programs that helped to keep drug costs under control for rural Louisianians.
It’s no coincidence that as Cassidy moves to undercut 340B, Big Pharma is lining his campaign coffers. Just last quarter, he pocketed $16,500 from employees at PhRMA, Eli Lilly, Sanofi, and Bristol Myers-Squibb — the same four drugmakers leading the charge against 340B. For a man who claims to represent Louisiana, only about a third of his donations last quarter actually came from Louisiana voters. The rest? Out-of-state interests, including Big Pharma.
This isn’t the first time Cassidy has cozied up to the pharmaceutical giants. During the 2024 election cycle, Big Pharma ranked as his fourth-largest source of campaign donations. In 2022, they were fifth. The money keeps flowing, and Cassidy keeps pushing policies that benefit drug companies at the expense of his constituents.
Read More: Bill Cassidy’s Cozy Relationship with Big Pharma Is Hurting Rural Louisiana
The Battle Lines Form As RFK Jr. Prepares to Take on Big Pharma Over Childhood Vaccines
But no matter, Cassidy will still name-check Donald Trump and declare his allegiance to the president's agenda, while touting his pro-life bona fides and endorsements, co-opting MAHA health plan tenets, and collecting Big Pharma money as he desperately tries to outrun his inconsistent and disingenuous record.
My record speaks for itself. No one in this race comes close. I’ve delivered real results for Louisiana working with @realDonaldTrump, and my fight for our country and our state isn’t over. pic.twitter.com/6tFFI8SWCo
— Bill Cassidy, M.D. (@BillCassidy) January 9, 2026
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