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One Thing: Are Lawmakers Taking Medical Privacy Too Far?
CNN 5 Things
Jul 12, 2026
Sen. Mitch McConnell (R-KY) has been hospitalized for nearly a month, but it remains unclear why or what his condition is. His prolonged absence comes just after Rep. Tom Kean Jr. (R-NJ) disappeared for over 100 days, for what he later revealed was treatment for depression. These incidents are reigniting a prickly debate over what information lawmakers owe voters, the limits of medical privacy, and if Congress is just too old.
Note: This episode was recorded before McConnell's statement revealing that his hospitalization was due to a fall. Read more here.
It was also recorded before the death of Sen. Lindsey Graham.
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Guest: Casey Burgat, The George Washington University Graduate School of Political Management
Host: David Rind
Producer: Paola Ortiz
Showrunner: Felicia Patinkin
Photo: Tom Brenner/Reuters
Episode Transcript
David Rind
00:00:00
This is One Thing, I'm David Rind, and when you're a member of Congress, medical privacy can get problematic.
Casey Burgat
00:00:06
'They don't need to see every single x-ray, but they need to understand that you're gonna be healthy enough to show up to do the job. Stick around.
David Rind
00:00:16
Back in 2023, then Senate Minority Leader Mitch McConnell suffered a concussion after a bad fall. He had to be hospitalized.
Senate Minority Leader Mitch McConnell
00:00:23
Well, good afternoon, everyone.
David Rind
00:00:25
But he was back at work on Capitol Hill in July of that year, addressing reporters.
Senate Minority Leader Mitch McConnell
00:00:30
String of, uh...
David Rind
00:00:32
When he just froze. For 20 excruciating seconds, McConnell stared straight ahead and said nothing before his colleagues came over to whisk him away. He later returned to the microphone later that day and seemed okay, but he froze again about a month later. His team said McConnell got lightheaded. He was 81 at the time. Now all of that was mysterious and concerning enough, but it pales in comparison to what has been playing out over the last month.
Brianna Keilar
00:01:07
Three weeks have passed since we learned that Kentucky Republican Senator Mitch McConnell was hospitalized, but why he's in the hospital and when he'll leave remain a mystery.
Audie Cornish
00:01:16
Has exclusively obtained video of the moment that the Kentucky Republican was taken by ambulance from his home. This happened on June 14th. Neighbors saw the Senator being loaded into an ambulance on a stretcher. Two ambulances, a fire truck, and Capitol police officers were also seen blocking off the street. Now the face of the person isn't visible in the video, but one neighbor told CNN that an eyewitness saw McConnell's face.
David Rind
00:01:42
His absence has fueled questions and sparked conspiracy theories. As of this recording, all his team will say is that he continues to improve and is working closely with his staff on Kentucky and Senate matters. President Trump said on Wednesday he had no idea how McConnell was doing, but some top Republicans like former aid and current CNN contributor Scott Jennings said they spoke with him on the phone this week.
Scott Jennings
00:02:03
Good to hear his voice. Voice sounded strong and sounded like he was keeping up with the news to me.
Kasie Hunt
00:02:07
Did you ask him how he was feeling?
Scott Jennings
00:02:10
Yeah, he said he was feeling okay, obviously well enough to call me on the phone.
David Rind
00:02:19
But McConnell is not the only lawmaker to take time away from Capitol Hill without telling the public why.
Congressman Tom Kane Jr.
00:02:24
This is not an easy speech for me to give.
David Rind
00:02:27
New Jersey Republican Congressman Tom Kane Jr. Basically disappeared off the face of the earth for nearly four months until CNN spotted him outside his home. He later returned to the House floor at the end of June to reveal that he had been diagnosed with severe depression.
Congressman Tom Kane Jr.
00:02:42
When I said I hope to return in a matter of weeks, I believed it. Those were the best estimates that the doctors could provide. But as the over 48 million of my fellow Americans being treated for this illness have come to discover, there is no timeline for healing.
David Rind
00:03:02
This is a bipartisan issue that goes well beyond Congress too. President Joe Biden dropped out of the 2024 presidential race after signs of decline became abundantly clear, and President Trump continues to get questions about bruises on his hands and swelling in his legs.
Karoline Leavitt
00:03:18
Recent photos of the president have shown minor bruising on the back of his hand. This is consistent with minor soft tissue irritation from frequent handshaking and the use of
Erin Burnett
00:03:27
The White House is revealing the President Trump has been diagnosed with a chronic condition called a Venus insufficiency
David Rind
00:03:35
So as political debates over questions of health and whether elected officials are too old continue, there are some immediate practical questions at play. Does legislative work still get done when the lawmaker stays home? Do constituents get any say in the matter? And what happens when younger voters see this play out again and again? Casey Burgett is the Legislative Affairs Program Director at George Washington University. He used to work on Capitol Hill for the Congressional Research Service, so he knows this place inside and out. So Kasey, can you just be straight with me? What are the rules around health disclosures for members of Congress? Are they required to tell us anything?
Casey Burgat
00:04:12
'Nada! There is no rule. We work on the honor system here. There is no legal requirement. There's no statute requiring them to disclose anything health-related. There are some modicum of financial disclosures, but they broke those rules all of the time. And health is the Wild West. We are dependent on them giving us the information they want us to have.
David Rind
00:04:35
And does that differ like for the president as well? Cause the president does release like health, you know, updates regularly.
Casey Burgat
00:04:42
Yeah, and those are voluntary. Also, they go through medical checkups and now it's just precedent because we're used to seeing the readouts from their their visits, but we don't know exactly what gets done there. And then we always get the same type of report from their handpicked physician saying everything looks good here. Let's move on.
David Rind
00:05:00
Did lawmakers even have to be present for a certain number of votes? Like, how does that work?
Casey Burgat
00:05:05
Yeah, this is not attendance in the classroom, right? You don't get marked off for your grade if you don't show up for it. And in fact, we've had periods for several members of Congress where they go months and months without any explanation, but their office still runs in their name. This is where you realize again, that a lot of the work on Capitol Hill gets done by their staffers, their hired aides in the members' names. So they can research bills, they can do a lot constituent casework, they can provide tours, the phones will get answered. The main things that can't get done when the members are not there is that they cannot vote in committee. They cannot vote on the House floor, the Senate floor. And then there's questions about can they introduce legislation? Typically, it's required that the member is there and present to submit it, but now a lot of things are done electronically. So are these bills being introduced coming from the member? Maybe, maybe not. A lot of the staff work is taken part on that work front too.
David Rind
00:06:02
So like when they're not there, that really does affect, you know, how the business gets done, at least on the floor when it comes to votes.
Casey Burgat
00:06:10
Legislatively for sure and within committee. It's not just voting. They're not there to to question witnesses They're, not there, to get the the advice of people Who are are within committees there and we've seen this particularly with mitch mcconnell's Situation where it can stall a lot of things He's a member of the appropriations committee one of the most important powerful committees. They have a one seat majority So if senator mcConnell is not there that is a divided vote. These things will not go forward uh confirming Justices confirming lifetime appointments or funding the government
David Rind
00:06:43
So nobody's taking attendance. They don't even have to like check in to explain where they are. That sounds unlike basically any workplace I've ever worked at. So like, why? Why is this okay?
Casey Burgat
00:06:58
Hold on who said it was okay. I'm not saying this is just the way that it is And the irony here is that the the only people who can change how the place works are the people who are existing in? This system in the first place they can pass a statute they can Pass a rule they can Pass a resolution requiring a lot of these disclosures But it hasn't been done before and and I don't know if there's a huge impetus for two for them to do it now
David Rind
00:07:22
Yeah, is there something to be said about, like, this particular moment in Congress where Republicans have such a narrow majority and, you know, they can't really afford to lose, you know votes one way or the other? So is there an incentive for them to kind of say, oh, everything's fine here, even though we haven't seen this guy in, you know, X number of days?
Casey Burgat
00:07:44
'Not only is there a little incentive, there's a huge incentive to do that, where you keep the seat in your party's name. You are just trying to get through one more vote, one more day, one more press release, knowing and hoping that this person comes back, because any absence affects how much you can get done legislatively, if at all. And so keeping that seat in your party's names The chambers differ on how they replace these members. So on the House side, there's no appointments for vacancies, meaning you have to go through a special election and depending on the state's rules, it could be kicked to the next midterm election. You lose that seat, right? You'd lose that vote. That is huge. Ask Mike Johnson how much that complicates when he has absences there. On the Senate side, you have an appointment through the governor's power. So it's just a delayed process. So it is- The incentive is there for you to keep the C in your name and just hoping and begging and pleading for these members to come back to give you the votes that you so desperately need.
David Rind
00:08:37
Has this gotten noticeably worse throughout history? Like, have politicians always been this cagey around this kind of stuff?
Casey Burgat
00:08:45
Let's just say they've never been extremely forthright about their medical disclosures. And in fact, there's been a lot of instances, particularly in the White House, of hiding a lot these big ticket health problems.
Documentary
00:08:58
In tranquil hills, gracious buildings, waters warmed by nature, Franklin D. Roosevelt successfully battled infantile paralysis to become a giant of world history.
Casey Burgat
00:09:12
I mean we start with FDR and his polio in the wheelchair that was not widely known even though that's common knowledge now, it wasn't at the time.
John F. Kennedy
00:09:20
This government, as promised, has maintained the closest surveillance of the Soviet military buildup on the island of Cuba.
Casey Burgat
00:09:31
JFK lived his life in incredible pain.
John F. Kennedy
00:09:34
A strict quarantine on all offensive military equipment under shipment to Cuba is being initiated.
Casey Burgat
00:09:40
He was taking a triglyceride during the Cuban Missile Crisis, and this was administered by a White House physician he invited in. Grover Cleveland hid a surgery that he took place out on the Long Island Sound for his mouth, and he was worried that if it came out, the recession would get even worse. So this is an American tradition, at least a presidential tradition, that you put out the best facts about you, health included, and you discount or outright ignore the facts that make you look good. Weak or sick or infirm in any way. The question of if it's getting worse or not, who knows, right? I think we have more reporters finding out. We have more access to information. We've never been more directly linked to these politicians and their offices. So it's a lot harder for them to hide. Anyone who's not showing up to work is not only missing out on those votes, the people back home from where they were elected are missing that representation. They're missing that voice within Congress and there's no one else to replace it with.
David Rind
00:10:41
And from what you're saying, it sounds like for those constituents who are frustrated that they're not being like physically represented in D.C., there's like nothing they could do about it.
Casey Burgat
00:10:50
There's literally nothing they can do about it except for making it an issue, making this a part of how they calculate who they want to serve in office, getting enough dust riled up where this becomes indefensible rather than a surprise anymore. That's the only recourse. There's no recall elections. You can't say you missed the buzzer rings and you missed 9,000 votes. You're kicked out of office. It doesn't work like that.
David Rind
00:11:12
Well, so it seems like the only recourse here is for voters to make their displeasure heard at the ballot box if a lawmaker is kind of hiding this, but has that ever come to pass where someone hasn't been transparent and then the voters say, hey, this is not right, we're voting this guy out?
Casey Burgat
00:11:32
Yeah, none are coming to mind which is part of the problem, right?
Former President Joe Biden
00:11:35
If they just paid 24% or 25%, either one of those numbers, they'd raise $500 billion, I should say.
Casey Burgat
00:11:44
Maybe the best equivalent is is President Biden's age after that first debate.
Former President Joe Biden
00:11:48
Look, if we finally beat Medicare...
Casey Burgat
00:11:54
And there was kind of this groundswell movement that ultimately forced him out of the race, but that wasn't at the ballot box. It was a groundswell of movement, even led by party elites.
David Rind
00:12:04
Well, and that one was so public and literally on TV for everybody to see, there was no hiding that one.
Casey Burgat
00:12:13
'Exactly, but they did for a while, right? Like and explained it away. This one was just like in front of your eyes So the more that people see their their elected officials not being up to the job That's that's where that that that information that you just can't explain away ideologically comes from but there's also a balance here Right like that voters are to blame because these ages are not hidden. They're not private information We knew that Feinstein was 88 when she was re-elected. We know that You know, Mitch McConnell was 82 when he was reelected. Like, we know these things. They're not unhidden. But at the same time, voters are faced with a binary choice. Your choice is, do I not put this person in because he's too old even though I agree with almost everything he does? Or do I sit out or elect someone else with whom I fundamentally disagree? So this is where you start rationalizing a lot of your choices. And the fact that we have so few leads us to make what we see as the best choice out of bad options.
David Rind
00:13:09
All right, we gotta take a break. When we come back, they say age is just a number, but as we've seen recently, it's way more than that. Stick around. Is this a frustration about elected officials like not being transparent, or is it about so many of them just being so old?
Casey Burgat
00:13:36
Yes, this is a yes is a answer all of these things. Yes, it is a frustration about them being old. We are one of the oldest cohorts within Congress. The median age is rising, rising, rising while people are living longer. Plus, we have so many high profile instances where you literally see it as a citizen with your everyday eyes, right? Where members of Congress and even presidents for that matter are are being led by staffers. They seem to be forgetful in certain moments. They still have all the powers of the office, but maybe not the capacity to fulfill them. And plus, there's just a widespread frustration with politicians in general. So they're looking for reasons to be mad, and this is a good one.
David Rind
00:14:12
I mean, is there something generational to talk about here, too, because I'm thinking about this idea of mental health specifically, like Congressman Tom Kaine said he took this long break for depression. Obviously, decades ago, there was a certain stigma around talking about mental health for just regular people, let alone politicians.
Casey Burgat
00:14:34
Yeah, two things can be true, right? Like this is bad from a representation component. If you're your member of Congress is not showing up to work, but also the reasons why they not show up can be a good progressive conversation nationally about mental health standards or for for now, increasing number of women politicians staying at home to to raise their kids in a paternity. They're not there to show up and vote. So those are national conversations we need to be having. And our policy should reflect those complications, right? It's not a black and white world. We should give people the space to have their mental health and raise their families and not reduce them or kick them out of the job because they have these very real human challenges.
David Rind
00:15:16
Yeah, I mean, I think even House Speaker Mike Johnson said about Cain that, you know, he wouldn't have like kept it quiet about this issue specifically, because like we've seen with John Fetterman, when he, you now, revealed his struggles with depression, he got a lot of like positive press for bringing an issue like that to the fore.
Casey Burgat
00:15:36
Yeah, I think there's a lot to be gained, both politically and just morally, by being honest and transparent. People will understand if they feel that you're not trying to hide the ball. They will give you some grace, maybe not the other side will give you complete grace, but a lot more will just understand because they're humans, too. I think the politicians start getting in trouble when they try to be cagey or outright misrepresent what's going on in their life. It leads people to to question their motives. And if we know anything about people questioning motives, they're gonna find that the worst reason to explain the behavior that they see in front of their eyes.
David Rind
00:16:11
I do want to be mindful of the privacy concerns, though, too, at the same time, because I'm sure most Americans want their full medical records on display or see pictures of themselves in a hospital bed start going around the internet. But is there a way to provide more information so that constituents have a fuller picture without violating that privacy?
Casey Burgat
00:16:31
'Yes, I think there's an infinite amount of room between only being reliant on what they tell you and then you plaster everything from your doctor's visits up on Reddit for everyone to see. There's a lot in between that space and I think that should be a genuine conversation between politicians bringing in the experts and lawyers to say what is a violation of their medical privacy and not. But honestly, this has been a constant tension of a private life a private citizen taking a very public role. And when you represent 750,000 constituents on the House side or multi-million constituents on the Senate side, you are forfeiting a lot of that privacy because you are taking such a public role. And the constituents demand that of their politicians. They don't need to see every single X-ray, but they need to understand that you're gonna be healthy enough to show up to do the job.
David Rind
00:17:21
I mean, you wrote about this recently in the sub stack, the preamble, you said, quote, McConnell's condition is his private medical information, his capacity to serve as one of Kentucky's two senators is a public matter. We have never developed a reliable way to separate the two. Can you expand on that? Cause like the capacity to sort of the ability for someone to actually do the job seems like the most important thing in all of this.
Casey Burgat
00:17:44
Exactly. I mean, they are elected to a position, they take the oath, only they can take a lot of the actions that we expect of our representatives and senators. And so the question of capacity is not just is this person able to get through the day, but is he going to disappear for for multi weeks at a time that has real implications, not only back home in Kentucky or Colorado, but nationally and internationally about funding the government we're in. Disputes with Iran and others and they take votes on these things We expect our politicians to hold the other branches of government accountable if they're not there with the capacity to Carry out all those functions. Then we are lessened as constituents and as a system of government It's all predicated on people doing the work
David Rind
00:18:28
But like how do you define that capacity to serve? Because everybody's different, right? Depending on what age you are, what kind of issue you're dealing with, everybody adapts to medical challenges differently. It would just seem hard to kind of have a baseline for saying, yes, this person is up to the job.
Casey Burgat
00:18:44
Yeah, and I think that's one of the main reasons that we don't have an advancement of this conversation. So let's start where the easy parts are. If you are not in office for an extended period of time and we can debate what that means, is that a week, is that month, is that three months or four months for Kayne in that instance, then should there be some sort of 25th Amendment equivalent where someone else is able to fill your capacity, fill your seat at least temporarily until voters have a right to decide? Right.
David Rind
00:19:10
Right, because that exists for the presidency, but for Congress, nothing like that is in place.
Casey Burgat
00:19:15
Not even close, not even close.
David Rind
00:19:16
I mean, what else? What other kind of fixes could you foresee being feasible?
Casey Burgat
00:19:21
'Yeah, I think so before we get into the conversation about age, if you reach a certain age, then you have to meet a certain criteria, whether it's an independent board of physicians, giving you a mental health capacity check and then reporting out just a disclosure, a required regular disclosure about your medical history. This is something you can file as a candidate if you're looking to take these seats. And then when you're in office, something regular that shows that you are. Meeting the standards of a certain medical capacity that the independent, non-biased, non-partisan physicians administer. I think that that's a step we can take where a lot of voters would nod their head and say, yeah, that makes sense, especially as we transition into this extremely historically old lawmaking class.
David Rind
00:20:06
I mean, yeah, voters might say, yeah that sounds great, but like you said, the members themselves would be responsible for putting this in place and it doesn't seem likely that they would have any appetite to do that.
Casey Burgat
00:20:19
Yes, those are two different questions. What could be done and what should be done are two very different questions and politics gets into play. But these things change when the public reacts so much, when they become so disgusted and so frustrated that it becomes tougher to explain for the politicians.
David Rind
00:20:34
Or they start seeing like late night comedians, you know, jumping in on it where it becomes like a constant punchline. That's gotta have some impact too, I would imagine.
Casey Burgat
00:20:43
'It does. It is, but it's where the voters lie. When they start worrying about their jobs, that's when you see them start to change their behavior. From the student perspective, they see such a disconnect between how they just see the ruling class being 90 plus years old. They don't see themselves represented. And so we just have a big disconnect at a time of distrust in government with a very old ruling class and a very young, non-interested citizenry.
David Rind
00:21:12
And what are the implications of having a citizen read that is disengaged in that way? They sit out.
Casey Burgat
00:21:19
'Right? They don't take a part in the system themselves, or even worse, they start dismantling the system just by their distrust. And it's very easy to lose trust from a citizenry about a governor, and it's a very, very hard to regain it. And so when they don't see themselves represented, not only are the policies different, not only is the attention of the ruling or lawmaking class different, the buy-in, the skin in the game from people who we really need to have skin in the game is just lessened over time.
David Rind
00:21:47
Casey, thank you so much. Really appreciate it.
Casey Burgat
00:21:50
Anytime, David. Thank you.
David Rind
00:21:54
All right, that's all we got time for today. Thank you so much for listening. We'll be back on Wednesday. I'll talk to you later.