Mary Landrieu has won a few odd elections — she may have met her match in a Republican physician.

Baton Rouge, La. — Mary Landrieu is Louisiana political royalty, but her reign as the state’s senior senator may come to an end this fall.

Like California’s Jerry Brown, New York’s Andrew Cuomo, and Arkansas’s Mark Pryor, Landrieu was born into Democratic politics. Her father, Moon Landrieu, served eight years as mayor of New Orleans before he became Jimmy Carter’s secretary of housing and urban development. Her younger brother Mitch was reelected as mayor of the Big Easy in February.


Landrieu is now facing a reelection battle of her own, and it will be the most difficult of her career. For Republicans, recapturing a majority in the U.S. Senate may hinge on her defeat.

The race is shaping up to be bellwether of sorts for the GOP’s chances to take over the Senate. The latest polls show her running neck and neck with her most formidable Republican opponent, Bill Cassidy, a 56-year-old congressman, but it won’t be an easy fight.

The nonprofit group Americans for Prosperity, which has spent nearly $30 million already this election cycle, is running ads against Landrieu in every media market in the state. But a source close to the group says the Louisiana race ranks just “sixth or seventh” on the group’s target list, behind races in West Virginia, South Dakota, Montana, Arkansas, North Carolina, and Alaska (in the first three of those states, the Republican is running for an open seat).


As it happens, the GOP needs to pick up six seats to recapture a Senate majority — a win in Louisiana could put the GOP over the top.


Landrieu, 58, has held public office for virtually her entire adulthood. She was elected to the Louisiana state house at the age of 25 and has fought to stay in public life: After losing a gubernatorial bid in 1995, she put her defunct campaign infrastructure to good use, turning it around to run a successful campaign for the state’s open Senate seat the following year.

In 1996, she had the help of President Clinton, who barnstormed the South on behalf of Democratic congressional candidates. She was also aided by Louisiana’s jungle-primary system, in which candidates of both parties appear on a single ballot. As six conservative Republicans duked it out among themselves, Landrieu gained ground. In the runoff, she beat Republican state representative Woody Jenkins by three tenths of a percentage point.


Republicans saw their next chance to take the seat in 2008 (in 2002, Republicans ran Suzie Terrell, a former elections commissioner with little name recognition). Much had changed in the years since Landrieu was first elected to federal office: George W. Bush carried the once-Democratic state in two close national elections, and Bobby Jindal was elected governor, while Democratic voter registration continually declined. Democrats accounted for 52 percent of Louisiana voters in 2008, down from 60 in 2000 (that number stands at 48 percent today, still higher than the registered Republican tally, 28 percent). Hurricane Katrina, too, had displaced more than 90,000 mostly African-American Democrats from New Orleans.


But Landrieu’s challenger, John Kennedy, wasn’t the ideal candidate for the increasingly red state: He had run for an open seat Senate seat in 2004 as a Democrat, and David Vitter emerged victorious in that election. As state treasurer in 2004, he had endorsed John Kerry, but he ran against Landrieu as a supporter of the Bush agenda. Landrieu was able to repurpose the opposition research Republicans had produced on Kennedy in his state-treasurer race, and one of her attack ads closed, “John Kennedy, one confused politician.” And, of course, Landrieu had Candidate Obama, in a state with a substantial share of black voters, to buoy Democratic and African-American turnout.

Over the past six years, Louisiana has become even more favorable to Republicans. In fact, Landrieu remains the only Democrat elected to statewide office. Since 2011, when Republicans gained control of the state senate for the first time since Reconstruction, the GOP has controlled every major statewide office. Mitt Romney carried the state by 17 points.


Landrieu has maintained her position in part by balancing the demands of the national Democratic party with the views of her constituents. She supports the Keystone pipeline and opposes cap-and-trade legislation. She recently became chairman of the Senate energy committee, where she can, and surely will, push for offshore oil and gas development, a move backed by the many companies that do business off Louisiana’s Gulf Coast.

In 2014, though, neither Bill Clinton nor Barack Obama is boosting Democratic fortunes at the top of the ticket, and right now, the Democrats’ troubled health-care bill appears likely to overshadow all other issues.

Many endangered Democrats have pled ignorance and turned quickly on the Affordable Care Act this year, but Landrieu has done a more delicate dance. She proposed a bill to allow people to keep health-insurance plans canceled due to the law, but she’s refused to back down from the president’s promise that Americans “can keep their plans.” She told The Weekly Standard in October, “We said when we passed that, ‘If you had insurance that was good insurance that you wanted to keep it, you could keep it.’” She also said in August that traveling to Europe made her ashamed of her own country because “their workers all manage to have health insurance that can’t be taken away.”

Enter Bill Cassidy, M.D., the Republican congressman determined to make Landrieu pay for her support for the law. A physician who has spent years treating the indigent in Louisiana’s charity-hospital system, Cassidy says he ran for Congress in 2008 so that he could play a role in the national health-care debate.

Over lunch at George’s, a dimly lit dive that sits under an I-10 overpass in Baton Rouge, Cassidy rails against Louisiana’s state hospital system, which he believes augurs poorly for the fate of Obamacare. By way of illustration, he tells me about a coworker, a Ugandan doctor who, after navigating his truck through the potholes that litter the drive to the entrance of the old Earl K. Long Medical Center, which closed last year, exclaimed, “I thought I was in Kampala!”


“When the bureaucrat has the power, the patient’s service suffers,” Cassidy says. President Obama and the Democrats who crafted the Affordable Care Act “never had my formative experience.”

That experience includes nearly three decades working with poor and uninsured patients, who constitute an above-average share of Louisiana’s population. In the wake of Hurricane Katrina, he mobilized a group of volunteers to convert an abandoned Kmart into a field hospital where he and others treated storm victims.

Cassidy specializes in liver disease and, when he is back home in Baton Rouge, oversees a hepatitis clinic, treating patients and working with medical students and residents. “My real love is liver disease,” he says at one point during rounds at his clinic, a statement that may never have been uttered by a congressman.

He is tall and square-jawed, with a serious mien, but he is quick-witted and almost joyous with patients and with his students. “You’re looking good man, you’re making some good changes in your life,” he tells a 41-year-old African-American man who has come to the clinic suffering from both Hepatitis C and HIV. Inspecting his arms, Cassidy asks, “Did you used to donate blood or shoot drugs?” Then, surveying extensive burn marks across the man’s chest, he inquires about them and learns the patient was scorched in a fire as a three-year-old. Cassidy puts his large hand on the patient’s shoulder and exhales. “Oh, man, I just feel sorry for you when you were three years old, buddy.” Before heading out of the exam room, he stiffens a bit and tells him, “Again, I’m Dr. Cassidy, and I’m also your congressman. If I can serve you as your congressman, let me know.”

Cassidy is not a career politician, and he takes flak from the right for not being conservative enough. In 1988, he supported Michael Dukakis over George H. W. Bush, and in 2002 he donated $500 to Landrieu, something she will surely throw at him in forthcoming debates. (The same year, Cassidy’s wife donated $1,000 to Landrieu’s runoff opponent, Suzie Terrell.) The Senate Conservatives Fund has endorsed Cassidy’s tea-party opponent, Air Force veteran Rob Maness, who has yet to gain ground in public polls.

The congressman tells me he’s gotten increasingly conservative over the years. “The facts of life are conservative,” he says.

Anticipating some of these attacks, Cassidy has gone out of his way to buck the party establishment. He lost his role on the GOP whip team earlier this month after opposing House leadership’s stance, and wasn’t shy about broadcasting it. He also resisted House speaker John Boehner’s attempt to put the issue of immigration on the table this year (Landrieu voted for the Senate’s comprehensive immigration bill last year).

At this early stage in the campaign, Cassidy seems to be getting traction. The most recent poll by the Democratic firm Public Policy Polling has him essentially tied with Landrieu. He is among the top five fundraisers on the Republican side in this election cycle — indeed, he’s raised nearly as much money so far as Landrieu herself (Landrieu has more cash on hand, though, $5.8 million to Cassidy’s $4.2).


Louisiana’s jungle primary, which goes to a runoff if no candidate gets 50 percent of the vote, takes place this November 4, general-election day in the rest of the country. If Landrieu and Cassidy finish as the top two, the runoff would be December 6 — and Cassidy could literally be the candidate who takes back the Senate for the GOP.

— Eliana Johnson is media editor of National Review Online.