How Sen. Bill Cassidy got to ‘yes’ on RFK Jr.

Bill Cassidy now expects to have “a great working relationship to make America healthy again” with Robert F. Kennedy Jr.

The Louisiana Republican said that and more on the Senate floor after voting to advance Kennedy’s nomination to lead the nation’s health agencies — five days after saying he was conflicted about Kennedy and grilled the nominee about his earlier assertions that widely accepted vaccines are unsafe.

Cassidy said he’d decided to cast the deciding vote to recommend Kennedy’s confirmation as Health and Human Services secretary to the full Senate after receiving assurances from Kennedy and the Trump administration that Kennedy would not dismantle the nation’s vaccine safety systems or take down government vaccine guidance. Already facing a primary challenge from his right, Cassidy had political reasons to come around — and Vice President JD Vance and Kennedy supporters pressured him to vote “yes.”

The Senate could now vote on Kennedy’s nomination in the coming days.

Cassidy, recounting conversations with Kennedy over the weekend and in the hours leading up to Tuesday’s vote, said he got a slew of commitments.

“He and I would have an unprecedentedly close relationship if he is confirmed,” Cassidy said, adding that the two will meet and speak “multiple times a month.” Kennedy also agreed to come before the health committee Cassidy chairs “on a quarterly basis” if requested.

Cassidy, who worked as a doctor before entering politics, said last week he was “struggling” with Kennedy’s confirmation because of Kennedy’s history of anti-vaccine activism.

According to Cassidy, Kennedy has promised to let Cassidy have input in filling key roles at the Department of Health and Human Services, that the Centers for Disease Control and Prevention would not take down information on vaccine safety or statements that say vaccines do not cause autism, or develop “parallel systems” on vaccine approval.

During his confirmation hearings, Kennedy repeatedly said he wanted to review vaccine safety data and release it to the public — something health agencies already do — and annoyed Cassidy by declining to acknowledge the medical consensus that the shots are safe.

Cassidy didn’t say whether Kennedy had renounced those views in private conversation.

But Cassidy said the evidence is clear. “The science is good. The science is credible. Vaccines save lives. They do not cause autism. There are multiple studies that show this,” he said.

Cassidy’s decision — along with other Senate Republicans' — to back Kennedy despite their concerns reflects President Donald Trump’s power over GOP lawmakers, as well as that of Kennedy’s “Make America Healthy Again” grassroots supporters. Cassidy said they had flooded his office with calls.

Vice President JD Vance also lobbied Cassidy, including just hours before he was to vote.

The pressure campaign centered on assuaging Cassidy’s concerns about Kennedy’s vaccine skepticism, while stressing that Kennedy agreed with Cassidy about other priorities, like combating chronic disease.

Cassidy will already face a challenge, should he decide to seek a third Senate term next year from former Republican Rep. John Fleming, who’s called Cassidy out for voting in 2021 to convict Trump of instigating the Jan. 6, 2021 riot at the Capitol. Voting against Kennedy would have further jeopardized a reelection bid.

While Cassidy said Kennedy agreed to maintain the CDC’s Advisory Committee on Immunization Practices, which makes recommendations on vaccines, the CDC director ultimately decides whether to sign off on the advisers’ recommendations.

Cassidy also said he was assured that Kennedy will allow the Senate HELP Committee chair to choose a “representative on any board or commission formed to review vaccine safety.”

A former CDC director suggested the assurances left big loopholes.

“Oversight hearings and oversight activities are pretty much after the fact,” Tom Frieden, who led the CDC during the Obama administration, said. “They don't ensure that there [are] real-time, protective measures that are taken. So they're important, they're necessary, but they're certainly not sufficient to protect Americans.”

Kennedy’s advisers still expect opposition on the Senate floor from Sen. Mitch McConnell (R-Ky.), who has refused to meet with Kennedy and reiterated in a “60 Minutes” interview on Sunday that vaccines are “critically important to health” and “a big deal to me.”

But other GOP senators who’d likely have to join with Democrats to defeat Kennedy don’t seem passionately opposed to the nominee.

Neither Alaska’s Lisa Murkowski nor Maine’s Susan Collins, both of whom have bucked Trump in the past, indicated the level of concern about Kennedy’s vaccine activism that Cassidy did when they questioned Kennedy at a health committee hearing last week.

Adam Cancryn, Robert King and Sophie Gardner contributed to this report.