Senator Bill Cassidy (R-LA) came in third in Louisiana's Republican Senate primary on Saturday - marking the first time in nearly 15 years that a sitting US Senator has lost a primary in a regularly scheduled election.
Instead, Trump-endorsed Rep. Julia Letlow led with ~45% of the vote, while state Treasurer John Fleming came in second at 28%.
Letlow and Fleming will now face off in a June 27 runoff.
Cassidy was a notable fan of Obamacare, and voted to convict Trump during impeachment over the Jan. 6, 2021 Capitol riot. He also helped sink Casey Means' nomination for surgeon general, which drew sharp criticism from Health Secretary Robert F. Kennedy Jr, and his MAHA movement. He's been labeled a big pharma shill by opponents.
Of note...
- Over $1.2 million in career contributions from the pharmaceutical and health products industry, according to OpenSecrets data, with hundreds of thousands received in recent cycles.
- Pharma executives showered him with donations shortly after he became the top Republican on the Senate HELP Committee in 2023, including $5,800 from Pfizer CEO Albert Bourla, $5,000 from Eli Lilly CEO David Ricks, and contributions from other PhRMA board members.
- Opposed key drug pricing reforms aimed at lowering prescription costs, while taking substantial industry money during those periods.
- Received nearly $330,000 from the pharma/health industry in the 2023-2024 cycle alone, ranking him among the top Senate recipients.
The last time a sitting US Senator lost their seat in a primary was in 2012, when longtime Sen. Dick Lugar (R-IN) lost his Republican primary to Richard Mourdock.
Letlow, meanwhile, is your standard issue conservative. The Louisiana congresswoman has a solidly right-leaning congressional record. She earned Trump’s full backing after Cassidy voted to convict him, and she campaigned on core America First priorities including border security, energy production, and opposition to woke policies.
While critics on the right point to her membership in the more moderate Main Street Caucus, slightly softer Club for Growth scores on spending, and past academic work involving DEI language, these are relatively minor compared to her overall alignment with Republican and MAGA priorities. In the context of Louisiana’s deep-red politics, Letlow represents a clear shift away from Cassidy-style establishment Republicanism toward a more Trump-aligned Senate candidate heading into the June runoff.