Nearly ten weeks later, what’s ailing Mitch McConnell?
Legislators represent us. Do they also owe us health updates? Northeastern University experts weigh in on the growing debate.
What’s ailing our electeds?
After a series of health problems led to a prolonged hospitalization, U.S. Sen. Mitch McConnell of Kentucky remains absent from the Senate and out of the public eye for ten weeks and counting. Kentucky Gov. Andy Beshear on Sunday said on CBS’s “Face the Nation” that, after days of writing to McConnell’s office, he has heard “absolutely nothing” about his status.
The McConnell episode underscores the ongoing concerns about the secrecy surrounding the health of the nation’s top leaders — one that dovetails with questions in recent years about the fitness and ability of an aging political elite to carry out their duties. Those conversations have sparked a larger one about the need for greater mechanisms of transparency around the health of politicians.
Each house of Congress has its own internal rules governing member behavior, but there are no formal laws or mechanisms requiring disclosure of health problems, said Christopher Bosso, a professor of public policy and politics at Northeastern University.
“In such instances, Congress historically views member attendance as a matter for constituents, who in theory can vote them out of office at the next opportunity,” Bosso said.
It’s also a tricky proposition because many of the levers of oversight ultimately run through the same political institutions — here, Congress itself — whose members have a stake in protecting their own party’s power, said Wendy Parmet, a professor at Northeastern University’s School of Law, who writes about public health law.
“There’s no easy solution to this problem,” Parmet told Northeastern Global News.
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The Senate’s standing rules stipulate that senators may not absent themselves from Senate service without leave. So far, it is unclear if McConnell formally sought leave. In order to achieve a quorum required to conduct business and vote on matters, lawmakers can compel an absent member to attend. Enforcement of the rules is discretionary and up to members, Parmet noted.
Health privacy law remains a formidable barrier to efforts at transparency. Health Insurance Portability and Accountability Act, or HIPAA, generally prohibits health care providers from disclosing patients’ protected health information without authorization, but it does not give members of the public a right to access a politician’s medical records. Nor can such records be obtained through a Freedom of Information Act (FOIA) request, which lists exemptions that “would constitute a clearly unwarranted invasion of personal privacy,” Parmet said.
There’s also little precedent or legal history to draw from.
“I don’t know that there could be any fruitful litigation because I can’t imagine that a court is going to want to do anything in a situation like this,” Parmet said. “There is tremendous deference to allow Congress to police itself, and people have a right to privacy.”
Political secrecy about health problems, especially at the executive level, predates both HIPAA and FOIA. Some of the more notable examples include former President Woodrow Wilson’s debilitating 1919 stroke, which left him incapacitated. Wilson’s physician and his wife concealed the extent of his condition from the public while effectively managing the flow of information to him. The pair had propped him up in bed to fool two visiting senators into believing he was healthier and more capable than he actually was.
Another well-known example is the concealment by former President Franklin D. Roosevelt of his paralysis from polio and advanced heart disease, which his doctors downplayed. Even after he was diagnosed with severe hypertension and congestive heart failure in 1944, Roosevelt’s doctor Ross T. McIntire represented to the public that his health was “excellent in all respects.”
Decades later, John F. Kennedy’s inner circle covered up his own serious health problems, including Addison’s disease, a rare chronic condition in which the adrenal glands fail to produce sufficient amounts of cortisol and aldosterone, and chronic back pain. The campaign helped the young president preserve his image of youthful vigor, Parmet said.
Now, the issue is sounding again. In May, Donald Trump’s White House circulated memoranda declaring the 80-year-old president in “excellent health.” Critics pushed back. During the previous administration, concerns about Joe Biden’s fitness became a central complaint on both sides of the aisle.
The House Committee on Oversight and Government even went as far as to subpoena Biden’s former physician, Dr. Kevin O’Connor, last year as part of a Republican-led probe into what they described as a cover-up of the president’s “cognitive decline.”
The U.S. Constitution has a remedy for the incapacity of a sitting president in the 25th Amendment, but Parmet noted that it isn’t much of a practical solution unless the people around the president are willing to use it. The history of its use has been limited largely to voluntary, temporary transfers of power during medical procedures, she said.
When it comes to McConnell and others, such as U.S. Rep. Thomas Kean Jr., who disappeared for 117 days due to clinical depression, Parmet said Congress could establish rules requiring members to make basic disclosures about their health, similar to the financial disclosures already required of lawmakers. But she cautioned against rules or laws that put pressure on members, or outright expel them, over absences linked to health concerns, calling that “a dangerous place to go.”
“I do think that having requirements for greater transparency so that the voters know what’s going on is not going to solve all the issues we’re talking about here,” she said.
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