When Senator Bill Cassidy of Louisiana recently brought Senator John Thune, the majority leader, to a local oyster bar, he called it a “Baton Rouge favorite.”
That description may no longer apply to Mr. Cassidy, though, if the lunchtime crowd there this week was any indication. As patrons trickled into Phil’s Oyster Bar and Seafood Restaurant, some muttered insults and declarations about never voting for him again.
“I like Trump,” Christy Meyer, a retiree from Bayou Blue, La., said on her way to lunch at the restaurant, which is plastered in Louisiana State University memorabilia and known for its charbroiled oysters. “He goes against Trump a lot.”
Mr. Cassidy did go against President Trump in 2021, when he was one of seven Republican senators who voted for an impeachment conviction after the Jan. 6 Capitol riot. He has spent considerable time since then trying to make amends. But for Mr. Cassidy, a physician who led a vaccination campaign in Louisiana and then backed Mr. Trump’s choice of a vaccine skeptic to serve as the nation’s health secretary, it wasn’t enough.
Mr. Trump upended Mr. Cassidy’s re-election bid last week with a surprise endorsement of a challenger, imperiling the senator’s already-shaky standing with Republicans back home.
To Mr. Cassidy’s critics on the left, it was poetic justice, proof that appeasement of Mr. Trump never pays off. To his right-wing detractors, it was confirmation of their suspicions that he wasn’t a true ally of the president.
And to some in Louisiana who have known the senator for years, it was another bitter twist of the Trump era.
The health secretary Mr. Cassidy helped confirm, Robert F. Kennedy Jr., has gone on to weaken the nation’s vaccine infrastructure, scaling back the slate of recommended childhood vaccines, canceling grants and contracts for vaccine development, and installing several inoculation skeptics on a key advisory committee. Along the way, he appears to have broken promises he made to Mr. Cassidy. And in the end, the president undercut the senator anyway, endorsing Representative Julia Letlow in an effort to unseat him.
What, some veteran Louisiana Republicans asked this week, was it all for?
“There was a widely held view that Kennedy should not have been approved, and that Bill was clearly in a position to prevent that from happening, and the only reason that he voted to approve him was to satisfy Trump,” said Jay Dardenne, a Republican former lieutenant governor whom Mr. Cassidy succeeded in the Louisiana Senate. “That’s all gone by the wayside.”
In many ways, Mr. Cassidy’s predicament is a familiar and cautionary tale of what can happen when Republicans cross Mr. Trump and then try to backpedal: It often ends badly.
“He’s got people within the party who think his vote to impeach was the kiss of death,” Mr. Dardenne said. Others, he said, “don’t like the fact that he’s been supportive of Trump and voted for Kennedy.”
Now, Mr. Cassidy faces a difficult road in a May election that will test the president’s second-term endorsement power and measure whether there is any room in Mr. Trump’s Republican Party for perceived dissenters — however dated or downplayed or disavowed their onetime criticism was.
“It’s such a messy, complicated political environment for someone like Senator Cassidy,” said former Representative Charles W. Boustany Jr. of Louisiana, who served as a Republican but opposes Mr. Trump.
Mr. Boustany, a Cassidy supporter who believes the senator is trying to pick his battles, added, “He has to consider taking positions that he firmly believes in, versus the calculation of how to get re-elected and to continue the work that he’s doing.”
Asked if there was a risk of angering everyone in the process, Mr. Boustany, who disagreed with the Kennedy vote, replied: “Yes, there is. And that is also one of the calculations that someone has to make.”
Caught in a Bind Over Vaccine Politics
Mr. Cassidy is not a bad guy, Sandy Lemoine, 70, declared over a pot roast dinner at George’s Southside, a dive-y favorite of Mr. Cassidy’s in Baton Rouge.
“He’s operated on my mother — he’s a good physician, he’s a good person,” said Mr. Lemoine, a Republican, as he coaxed his toddler grandson to eat his catfish.
But ever since the pandemic, Mr. Lemoine said, he has become more skeptical of vaccines.
“I’m looking for new medicine, new ways of treating the same illnesses we’ve had for years and years,” he said. “I don’t think his mind is open to that. That bothers me.”
Polling shows that vaccine skepticism has grown considerably among Republicans. A Pew Research Center survey last fall — conducted during a year of devastating measles outbreaks — found that just 52 percent of Republicans said that healthy children should be required to get the measles, mumps and rubella vaccine to attend public school. That was a sharp drop from the 79 percent who said so in 2019, before the pandemic.
Those numbers help explain why some Republicans have not been receptive to Mr. Cassidy’s sharp questioning of Mr. Kennedy, and why his reluctant vote to confirm him didn’t seem to win him many points with the conservative base.
“The R.F.K. vote, to me, was a net detriment to him,” said John Couvillon, a Louisiana-based pollster who has worked in the past with other candidates in the race, and who is working this year for John Fleming, the state treasurer and another Cassidy challenger.
Mr. Cassidy’s hesitancy to confirm Mr. Kennedy irritated Republicans, Mr. Couvillon suggested, and “by voting for R.F.K., any good will he might have gotten from those on the Democratic side of the aisle dissipated.”
Mr. Cassidy declined an interview request.
“Senator Cassidy has the support and resources needed to win, keep Louisiana red and help maintain the G.O.P. Senate majority,” his campaign manager, Katie Larkin, said in a statement.
This year, Louisiana is moving to a closed-party primary system in which only Republicans, and unaffiliated voters who choose a Republican ballot, can participate in the G.O.P. contest.
In Louisiana, some non-Republican voters seem disinclined to go to bat for Mr. Cassidy.
“I have in the past voted for Cassidy,” Wendi Pounders, 62, an unaffiliated voter, said in an interview outside a Trader Joe’s. She is uncertain about whether she will do so again, disappointed by his support for Mr. Kennedy and put off, she suggested, by the Trump-era Republican Party.
“I don’t like anything to do with Trump,” she said. Speaking in a low voice, she added, “You can’t say it very loud around here because people will scold you. It’s very upsetting.”
Lisa Delpit, 73, a retired professor and a Democrat, said she was unsure whether she could support Mr. Cassidy if he made it to the general election, especially after his vote for Mr. Kennedy.
“I believe he went against some of his own beliefs as a physician,” she said. “About vaccines. About children’s health. About a lot of things.”
‘It’s Going to Be Messy’
Mr. Cassidy’s advisers concede that this race will be challenging.
But, they note, he is a well-funded, battle-tested candidate with strong name ID and ample resources to communicate his message and turn out voters. The impeachment vote, his advisers hope, is already accounted for in the minds of voters, and they see room to expand his appeal. (Other political strategists and rivals say they anticipate many fresh opportunities to remind voters of that impeachment decision.)
And it’s hard to beat an incumbent who can say he has delivered tangible accomplishments to his state.
“If you judge who wins by a record of achievement for the state of Louisiana and for the United States of America, my record would not be matched by any of the others,” Mr. Cassidy told reporters on Tuesday. “The crux of the campaign will not be about endorsements.”
The Louisiana Senate primary race is one of several upcoming contests that will illustrate the direction of the Republican Party in Mr. Trump’s second term.
In Texas, Senator John Cornyn faces a challenge from the state’s right-wing attorney general, Ken Paxton. In Kentucky, Representative Thomas Massie, a libertarian-leaning congressman who has challenged the president over foreign policy and the Epstein files, faces a Trump-backed challenger. In Maine, Senator Susan Collins, a Republican who joined Mr. Cassidy in voting to convict Mr. Trump, faces a difficult general election, as the president recently declared that she should never be re-elected.
And in Louisiana, Mr. Cassidy, who has the support of Senate Republican leaders, is being pushed from the right.
Mr. Trump’s endorsement of Ms. Letlow, who has been in office about five years and isn’t regarded as a right-wing firebrand, is likely to be powerful.
But other candidates could appeal to the MAGA base, and it’s not yet clear how many will step aside for Ms. Letlow; one candidate dropped out on Thursday.
Gerry Arnold, 69, is no Cassidy fan, and she likes Mr. Trump. But his endorsement, she said, is not determinative. Asked if it was meaningful, she replied, “somewhat.”
“He’s a bit rash,” she said. “I take it with a grain of salt.”
Mr. Boustany called the primary a “bellwether.”
“Cassidy’s victory is a victory for getting back to some core principles that the Republican Party has long espoused since Eisenhower,” he said. “I do think votes for other candidates are votes for more extremism and positions coming from the hard right.”
Tony Perkins, the president of the conservative Family Research Council and a former Louisiana state legislator, was succinct as he summed up the race.
“It’s going to be messy,” he said.
Kitty Bennett and Sheelagh McNeill contributed research.
Katie Glueck is a Times national political reporter.
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