BATON ROUGE, La. (AP) — Sen. Bill Cassidy has emerged as a central figure in the confirmation of Robert F. Kennedy Jr., whose nomination to health and human services secretary poses an equally consequential moment for the second-term Republican facing an uncertain political future in Louisiana.

A physician-turned-politician, Cassidy has questions about Kennedy’s past claims linking common vaccines to autism, a position the gastroenterologist rejects and sought repeatedly to convince the nominee to renounce during a committee hearing Thursday.

Yet, Republicans and voters at home in the state President Donald Trump carried handily are pressing Cassidy, who is up for reelection in 2026, to vote yes.

Already at odds with a segment of his party for voting to convict Trump during his 2021 impeachment, Cassidy acknowledged his own desire Thursday to see Trump succeed in his second term as president. His questioning of Kennedy on Thursday demonstrated vividly the conflict between Cassidy’s medical views and his desire to be an ally to the president and his supporters.

Ultimately Cassidy stopped short of saying whether he will vote to approve Kennedy’s nomination, though the hearing did offer some clues.

“You may be hearing from me over the weekend,” Cassidy said.

There was no ambiguity from Louisiana Republicans in their advice to Cassidy.

Prominent party members, including the state GOP’s organizational leader, vocal conservatives and a potential primary challenger, made clear in their public signals to Cassidy that he would be flouting the will of the party were he to oppose the nominee of a candidate who carried Louisiana so handily.

State Surgeon General Ralph Abraham, state Republican Chair Derek Babcock and a conservative coalition in the Louisiana House of Representatives that adopted its congressional counterpart’s title, the Freedom Caucus, all wrote to Cassidy urging him to vote to confirm Kennedy.

Republican Gov. Jeff Landry’s letter sent perhaps the clearest signal to Cassidy. In a letter to Cassidy, his former House colleague and longtime Trump devotee recalled Kennedy’s appearance in Baton Rouge, and noting “Kennedy proved to be an asset to the state as we navigated the edicts of the federal government.”

Republican State Rep. Raymond Crews said Cassidy’s standing among Louisiana Republicans is riding on his vote on Kennedy.

A vote against Kennedy “wouldn’t match up with the country, and it particularly doesn’t match up with the state of Louisiana,” Crews said.

Cassidy acknowledged in his opening to the committee Thursday what Louisiana statehouse Republicans have noticed: Kennedy has a following in Louisiana.

“My phone blows up with people who really follow you,” Cassidy said, noting the calls he gets urging him to vote to confirm. “And there are many who trust you more than they trust their own physician.”

That’s, in part, due to Kennedy’s appearance before a packed 2021 Louisiana legislative committee hearing in Baton Rouge, when he joined in opposition to then-Gov. John Bel Edwards’ proposal to add COVID-19 vaccinations to the list of shots required for Louisiana public school students.

At the invitation of then-Louisiana Attorney General Jeff Landry, Kennedy was hailed during the visit to Baton Rouge by opponents of the Democratic governor’s proposal, many of them part of organized parent groups.

The appearance endeared Kennedy to opponents of Edwards’ measure, which was defeated in the Republican-controlled legislature, said Louisiana Rep. Julie Emerson, a member of the House Health and Welfare Committee at the time.

“He’s a bit of a folk hero in Louisiana because of that,” Emerson said.

Cassidy is already unpopular with a segment of Louisiana Republicans for voting in January 2021 to convict Trump after his second impeachment stemming from the Jan. 6, 2021, attack by Trump supporters on the U.S. Capitol. Cassidy’s vote came right after he was sworn in to his second term.

He has drawn a primary challenger in state Treasurer John Fleming, and others are considering entering the race against him. Louisiana last year adopted a closed party primary election system, abandoning the “jungle primary,” which would have given Cassidy a smoother path.

Before, all candidates for Senate — Republicans, Democrats and third-party candidates — ran in the same open primary, where all registered voters could vote. If a candidate didn’t get 50 percent in that vote, the top two would face a runoff. That system favored better-known candidates with cross-party appeal. The new primary would draw registered Republicans and GOP-leaning independents.

Trump, who puts a premium on loyalty to him, has long been troubled by Cassidy for his impeachment vote, say Louisiana Republican insiders, few of whom see any scenario where Trump endorses him. The best possible outcome for Cassidy could be, even if he votes to confirm Kennedy, for Trump to endorse no one.

Still, a vote against Kennedy would be out of step for Cassidy within his state’s party, said state Sen. Blake Miquez, a potential Cassidy primary challenger.

“We shouldn’t be playing the old D.C. games intended to obstruct Trump’s agenda,” he told The Associated Press.

Cassidy approached the hearing with obvious nods to his competing allegiances, as a doctor and an elected official representing a state where Trump won 60 percent of the vote.

“I want President Trump to be successful,” he said in opening the hearing of the Senate Health, Education, Labor and Pension Committee he chairs.

Still, Cassidy sought to elicit from Kennedy — pointedly, if also politely — a commitment to recant statements linking vaccines for measles and Hepatitis B to autism, a connection that has been widely debunked by medical researchers.

Twice during the hearing, Cassidy recalled his 18-year-old patient suffering acute liver failure who needed emergency transplant surgery, which would burden her with medical bills for the rest of her life. “Fifty dollars worth of vaccine could have prevented this all,” the liver disease specialist said.

“Your past undermining confidence in vaccines with unfounded or misleading arguments concerns me,” he said.

Initially, Kennedy seemed conciliatory: “If you show me data, I will be the first person to assure the American people that they need to take those vaccines.”

Dissatisfied, Cassidy said he was concerned “that you’ve never acquainted yourself with anything that might contradict what you were previously saying.”

Then Cassidy took another crack, this time conceding to Kennedy’s terms to see the data first. “If the data is brought to you, and these studies have been out there for quite sometime,” he said, “will you say, ‘I see this. It’s stood the test of time.’?”

Offered that caveat, Kennedy was happy to oblige.

“Not only will I do that,” he said, “I will apologize for any statements that misled people otherwise.”

Asked by reporters in the days leading up to the hearings, Cassidy said: “I’m still working through it. I look forward to the hearings and I will allow that to guide my decision.”

By suggesting Thursday to Kennedy at the close of the hearing that he might reach Kennedy over the weekend, Cassidy seemed to suggest his concerns had not been allayed.

Repeating in his closing remarks his desire for Trump to succeed, Cassidy returned to Kennedy’s answer that he would promote vaccines he had criticized as long as someone demonstrated their safety.

Cassidy said he and Kennedy agreed that families wanted vaccines that were necessary, safe and effective.

“But we’ve approached it differently,” he said with an air of understatement.

“I think I can say that I’ve approached it using the preponderance of evidence,” he said. “And you’ve approached it using selective evidence to cast doubt.”

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Beaumont reported from Des Moines, Iowa.

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