Louisiana Senate Showdown Tests Maha’s Political Power

Leaders of the Make America Healthy Again movement have pitched themselves as a political force that will make or break GOP prospects in the midterms. But they have yet to make a splash in the only Senate primary where they have entered the fray — Republican Sen. Bill Cassidy’s battle to fend off two challengers to his Louisiana seat.

MAHA Action, the advocacy arm of the movement, has endorsed Rep. Julia Letlow (R-La.), but its efforts may prove insufficient. Its affiliated MAHA PAC pledged to spend just a million dollars — a small amount for a Senate campaign — to boost her chances of toppling Cassidy, whose tough questioning of HHS Secretary Robert F. Kennedy Jr. as a committee chairman has made him a top movement target.

Meanwhile, a local MAHA group with concerns about Letlow’s past support for vaccines has not joined forces with MAHA Action while Kennedy, MAHA’s founder, is preparing a national midterms blitz that does not include Louisiana.  

Defeating Cassidy — arguably the highest-profile Republican to challenge Kennedy’s rhetoric and policies on vaccines — would be a coup for the nascent movement. Yet MAHA’s backing has not yet given Letlow a commanding lead in the polls, nor has it succeeded at putting its top issues, like vaccines, food safety, and environmental contamination, front and center in the race.

“I've honestly not heard the word ‘MAHA’ mentioned other than in the context of the PAC donating to Letlow’s campaign. It's really not an issue,” said John M. Couvillon, a longtime Louisiana pollster and political analyst who has worked on behalf of John Fleming, the third GOP candidate in the race. “The race is about either Donald Trump or about various imperfections” in each candidate’s record, he said.

MAHA PAC leader Tony Lyons said his group is the largest donor to Letlow’s campaign and her polling has “gone up dramatically” since its endorsement — claims borne out by recent surveys and fundraising reports.

“MAHA issues are in fact central to this race and to races all around the country, where in many cases they poll higher than most other issues for voters, especially for the all-important undecided voters,” he told POLITICO in a text. “It’s true that Big Pharma and big food would like to convince voters otherwise, but Julia Letlow is a strong insurgent candidate and she will win.”

In a statement to POLITICO, Letlow said she's proud to have MAHA's endorsement.

"We share the same beliefs that families deserve better, that our system should put people first, and that it is time to restore trust and deliver real results for the health and future of our children," she said.

Yet Cassidy, despite dealing with blowback from the GOP base and MAHA, is holding his own. While most polling shows Letlow with a slight lead, all three candidates have a credible shot at qualifying for the June runoff.

With the May primary just weeks away, the race will test MAHA’s political power. Can the movement become a major national player as its PACs and advocacy groups expand their endorsements and target lists ahead of November? Or was its 2024 boost for Trump an anomaly?

As the MAHA coalition fractures amid disappointment with the Trump administration, the Louisiana Senate battle and broader midterm outcomes could also reveal whether the movement can assert its independence and make meaningful progress on policy issues or will exist solely as a Trump-aligned group that remains influential only while Trump is president.

MAHA PAC and MAHA Action have so far had a scattershot electoral strategy, endorsing a smattering of gubernatorial and state legislative candidates in red and purple states. And, despite polling showing that many MAHA voters are disappointed in the administration’s health policy record and view Democrats favorably on a number of priority issues, Lyons has vowed to only back Republicans who are “willing to get on board with the team that the president has set up.”

Some rank-and-file MAHA advocates worry that strategy will limit the movement’s appeal and political impact by alienating potential supporters.

Claire Dooley, a MAHA activist who has worked with Kennedy and the anti-vaccine advocacy group he founded, Children’s Health Defense, called it “unreasonable,” arguing that “MAHA is made up of people who are not exclusively Republican,” counting herself in that category.

Dooley added that she hopes MAHA one day becomes “a completely new party” — or, at the very least, a powerful outside force that "scores" all elected officials on their policy records, as influential anti-abortion groups and other conservative advocates do.

“I would like to see, in every state, a much more organized campaign saying, ‘These are the MAHA approved candidates.’ But I don't think we're there yet,” she said. “Maybe there’s just a lack of manpower and resources at this time. But MAHA is really building its presence in DC and trying to find a more permanent place here.”

Louisiana is — in some ways — an ideal proving ground for the growing MAHA movement. Republican Gov. Jeff Landry has publicly aligned himself with Kennedy’s agenda, state lawmakers have sponsored bills to de-fluoridate tap water and ban some food dyes and artificial sweeteners from public school meals, and the state health department recently stopped encouraging mass vaccination.

Yet MAHA policy issues have not emerged as central to the race. Messaging from all three campaigns has also focused primarily on standard Republican issues like crime, immigration and — above all — the cost of living. That reflects what Louisiana voters say are their top priorities. A nonpartisan poll in February found that cost of living and the economy are residents’ overriding concerns headed into the midterms, while crime and health care tied for a distant third place.

“They're grassroots, they're loud, they make noise, but sometimes it doesn't materialize,” Kelby Daigle, chairman of Louisiana’s St. Martin Parish GOP, said of Louisiana’s MAHA activists.

More than anything else, the race has become a contest of who is the most loyal to Trump, a mantle all three candidates are trying to claim.

Letlow has attacked Cassidy for his 2021 vote to impeach Trump — a move many predicted would doom his reelection chances as it did for most of the other GOP lawmakers who broke party ranks that year. Meanwhile, Cassidy has touted his work on health and immigration bills Trump signed into law, and Fleming has cast himself as the most conservative candidate who would advance Trump’s agenda.

Even if Cassidy loses, argued a former staffer of the senator, granted anonymity to discuss his former employer, it will be because of Trump, not MAHA.

“The party is firmly under Trump, I think, more so than ever before,” the staffer said. “So to some extent, [MAHA] is riding his coattails.”

Indeed, the MAHA PAC endorsed Letlow after Trump publicly urged her to run, and its messaging has leaned more towards attacking Cassidy than holding her up as a champion of the movement. On MAHA Action’s weekly call for activists and reporters in early April, Lyons praised Trump’s “courage and leadership” but offered only muted praise for Letlow, saying she was “really open to the issues that matter to the MAHA movement,” and “willing to learn with us.”

MAHA PAC, meanwhile, has only spent a small fraction of the $1 million it promised to Letlow — purchasing a mailer supporting her campaign and another attacking Cassidy, a text blast, and some digital ads. The group plans to ramp up spending as the May primary draws closer, and there is evidence her campaign sorely needs it. Letlow has $2.3 million in cash on hand, compared with Cassidy’s $8.5 million. Cassidy has been massively outspending Letlow since she joined the field in January, three days after Trump urged her to run.

The movement’s anemic showing in the Louisiana race calls into question its national impact. While MAHA PAC has set an ambitious goal to raise $100 million to influence midterm races, it raised only $50,000 in February and has just about $400,000 in the bank, according to a federal election spending report.

Other MAHA-aligned groups in Louisiana, meanwhile, remain skeptical of Letlow and are not rallying behind her campaign. The anti-vax advocacy group Health Freedom LA blasted MAHA PAC for endorsing her, citing the congresswoman’s support for Covid vaccinations in the wake of her husband’s death from the virus. But rather than backing one of Letlow’s opponents, they are sitting out the race entirely.

“No candidate’s record on vaccines satisfies me, least of all Bill Cassidy’s,” its leader Jill Hines told POLITICO.

Hines and other MAHA diehards remain upset with the senator for reluctantly backing Kennedy for HHS secretary and for aggressively questioning surgeon general nominee Casey Means, a wellness influencer and MAHA leader, over her views on vaccines. Letlow has gone after Cassidy for not revealing if he supports Trump’s pick, whose nomination remains stalled in the Senate.

Cassidy has since made some overtures to the movement, arguing in a recent press call last week that he aligns with MAHA on “getting out ultra-processed food” and that he is “the reason that Robert F. Kennedy is now the secretary of HHS.” He also predicted that MAHA activists who oppose his support for vaccines will come around in light of “an outbreak of measles in the thousands, with children dying.”

"I'm not really quite sure what MAHA's beef is,” he said. “If folks want their children to be healthy, and they themselves to be healthy, [they should] vote Bill Cassidy.”

Yet wooing MAHA is not a priority for Cassidy’s campaign. Asked how the senator plans to convince activists in the movement to vote for him in May, a campaign advisor granted anonymity to discuss internal strategy offered no specifics.

“Our mission is to get everyone to vote for Senator Cassidy,” the advisor said. “There's some issues [MAHA] might agree with him on, and there's some issues where they might disagree. But he always wants to do what's right for the people of the state.”