A political action committee based on the Make America Healthy Again movement is pledging to spend big in the midterm elections, betting that wellness issues will drive Americans to the polls. The MAHA PAC’s ambitions are already figuring prominently in Louisiana Sen. Bill Cassidy’s bid to retain his seat by backing one of his main opponents, Rep. Julia Letlow, R-La., to the tune of $1 million.
Targeting Cassidy makes sense for the MAHA faithful, who want to reduce the role of vaccines in public health policy. Cassidy has been one of the strongest Republican supporters of vaccines in Congress, voicing concerns about Robert F. Kennedy Jr.’s attacks on them despite ultimately supporting Kennedy’s nomination for Health and Human Services secretary.
But the MAHA movement faces the challenge of touting its agenda on nutrition and ultra-processed foods without losing the support of Americans who back access to vaccination by and large. Polling shows less than half of Americans now trust federal agencies to make childhood vaccine recommendations. And Louisiana voters may have other priorities than health issues when at the ballot box.
Cassidy’s trajectory
Cassidy, who’s had a strained relationship with President Donald Trump since he voted to convict the president at his impeachment trial after the Jan. 6, 2021, Capitol attack, has struggled to get into Trump’s good graces before the primary in May.
Cassidy had expected Trump to stay neutral but was thrown a curveball in January when Trump endorsed Letlow even before she had announced her decision to run. A day later, the MAHA PAC pledged to pour $1 million into her campaign fund. After launching her campaign on Jan. 20, Letlow welcomed MAHA’s endorsement.
“I’m thrilled to have the support of the MAHA PAC in my run for U.S. Senate as we confront the chronic disease epidemic and stand with President Trump to Make America — and Louisiana — Healthy Again,” she wrote on X.
Letlow joined Congress under unique circumstances. Her husband, Luke, died of COVID-19-related complications in 2020, just days before he was scheduled to be sworn in to represent Louisiana’s 5th District in the northeastern part of the state. Julia Letlow then went on to win the seat in March 2021 in a special election.
When the COVID-19 vaccine became available later in 2021, Letlow worked to dispel misinformation and encourage people to take it.
“My prayer is that not one more person has to lose their life to this virus. It is a horrific way to leave this world. I don’t wish it on anyone else. We have the answer. Let’s use it,” Letlow said in a 2021 interview with CBS News.
Now, Letlow has found herself at a pivotal point in her political career.
The MAHA movement, which emerged from Kennedy’s presidential run in 2024, touts several health issues, like nutrition and avoiding ultra-processed foods, that have historically garnered bipartisan support. The group has also pushed for reforms to vaccine policy and has cheered the end of universal availability of COVID-19 shots.
But it also recognizes the difficulty in its stance on vaccines. In a memo sent to Republican leadership last month that was obtained by Politico, Tony Lyons, CEO of MAHA advocacy groups, advised caution when talking about the issue of vaccines in the midterms. Instead, he emphasizes the importance of family choice in medical decisions.
Speaking during a Heritage Foundation event last month, Lyons said the group is following Trump’s lead on endorsements in Congress. He said the group had met with Letlow’s team and wants to back her proposals for medical freedom and healthy school lunches.
“We think there’s a really great partnership that we can have with candidates all around the country to help them win,” he said.
The PAC has pledged to spend as much as $100 million in the midterm elections, The Washington Post reported late last month.
A request for comment sent to the PAC did not garner a response.
Voter priorities
Robert Collins, a public policy professor at Dillard University, said vaccines won’t be at the forefront of voters’ minds this fall. He said Trump’s endorsement will go further.
“The voters tune out the noise, and they focus on the signal,” he said. “And they got their signal from Donald Trump.”
Collins said for Louisiana voters, the issue of vaccines amounts to “inter-party squabbles” over a issue that many see as fading into the past alongside the pandemic.
“I still think people down here have strong opinions about the vaccine, but I don’t see it spilling out into changing anyone’s votes,” he said.
But the apparent contradiction for Letlow hasn’t gone unnoticed.
Robert Mann, an emeritus professor at Louisiana State University who spent a career in communications for Democratic Louisiana officials, said it appeared “unseemly” for Letlow to accept the funds, given her past support for the vaccine.
“She certainly hasn’t denounced them or tried to separate herself from them in any way,” Mann said. “She seems to be fine with, at least tacitly approving of, what they’re doing on her behalf, and this is a group that is populated with just a lot of anti-vax people.”
Mann also noted that Cassidy’s crucial vote in committee for Kennedy’s nomination “didn’t buy him any goodwill,” in that Trump endorsed his opponent.
Cassidy, who chairs the Senate Health, Education, Labor and Pensions Committee, and Letlow have had nearly identical voting records during the first year of Trump’s second term. They both boast nearly 100 percent presidential support scores in the past year, including support for Trump’s landmark 2025 GOP reconciliation law.
The primary is a crowded one. In addition to Cassidy and Letlow, Louisiana Republicans will have the option to choose state Treasurer John Fleming. A poll conducted by John Couvillon of JMC Analytics and paid for by Fleming found that Cassidy, Letlow and Fleming were all within a few points. The survey of 645 likely Republican primary voters had Fleming ahead at 26 percent of the vote, Letlow with 25 percent and Cassidy with 22 percent.
Further complicating the primary is Louisiana’s new “closed” primary system in which candidates from each party run in their own races, meaning that the primary contestants are competing for an even more conservative pool of voters than in years prior.
“You’re the incumbent senior senator from Louisiana and in a party primary — not among the general electorate, but among your own party — you’re polling 20 to 30 percent? That’s not good,” Mann said.
Collins echoed that sentiment, underscoring that Cassidy’s deep war chest should have put him ahead of the pack.
“He’s in very deep trouble,” Collins said. “You would think a long-term incumbent that’s sitting on tens of millions of dollars should, at the very least, be running first right now, and he’s not.”
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