Health Concerns For PA Senators Raise Issues

Bob Casey, John Fetterman

It has been 40 years since the Super Bowl was not the most-watched U.S. TV broadcast of the year.

The ratings for the Redskins-Dolphins game were eclipsed by the final episode of M*A*S*H.

As the Philadelphia Eagles prepare to take on the Kansas City Chiefs on Sunday, there is more medical drama that is attracting attention. And it involves Pennsylvania’s delegation in the U.S. Senate.

The Commonwealth’s junior senator – John Fetterman – suffered a stroke in May and is afflicted with a neurological condition that impairs his hearing. Now, he has been hospitalized since Wednesday after the former lieutenant governor felt lightheaded.

A story from the New York Times shares the challenges faced by the 53-year-old Fetterman even before his recent episode. “His adjustment to serving in the Senate has been made vastly more difficult by the strains of his recovery, which left him with a physical impairment and serious mental health challenges that have rendered the transition extraordinarily challenging – even with the accommodations that have been made to help him adapt.”

Pennsylvania’s senior senator – Bob Casey – recently announced that he will be undergoing surgery for prostate cancer.

Others have faced this diagnosis as well. John Kerry was running for president in 2003 when he announced he would undergo surgery. Bob Dole continued his presidential run in 1996 after his diagnosis, while Rudy Giuliani gave up his Senate run in 2000 after receiving his news.

More recently, Sen. Thom Tillis (R-NC) had prostate surgery in 2021 and returned to the chamber after missing 4-5 weeks.

A rough-and-tumble campaign against Republican nominee Mehmet Oz brought out questions of Fetterman’s ability to serve in the “world’s most deliberative body.” And until his doctors perform the surgery, the prognosis for Casey’s full recovery and return to the Senate, although bright, is unknown.

What would happen if one or both of Fetterman and Casey were unable to continue serving in the Senate? How would Pennsylvania determine replacements in the 100-person chamber?

The Seventeenth Amendment, adopted in 1913, allows state legislatures to empower the governor to appoint a replacement if the vacancy occurs due to a senator’s death, resignation, or expulsion. The appointment can cover the remainder of the term or until a special election can take place.

Presently, 37 states, including Pennsylvania, fill Senate vacancies at their next regularly scheduled general election. The person elected in that general election serves for the remainder of the unexpired term, if any. If the term was set to expire at that general election, the person elected serves a full six-year term.

That translates to Gov. Josh Shapiro having the ability to make an appointment to fill the term until the next statewide general election – November 7, 2023. The winner of a 2023 special election to replace Casey would serve throughout the 2024 calendar year. A similar special election to choose a replacement for Fetterman would finish out his term which is set to expire in 2028.

Pennsylvania’s Appointed Senators (5)

  • Harris Wofford (D), May 8, 1991 (elected November 1991)
  • Joseph Grundy (R), Dec. 11, 1929 (defeated for nomination)
  • David A. Reed (R), August 8, 1922 (elected November 1922)
  • George W. Pepper (R), Jan. 9, 1922 (elected November 1922)
  • William E. Crow (R), Oct. 17, 1921 (died on August 2, 1922)


Recent Senate appointments have occurred in Arizona and New Jersey, following the deaths of Sen. John McCain and Sen. Frank Lautenberg. After McCain’s passing, former Arizona Gov. Doug Ducey chose then-Rep. Martha McSally, a Republican, to fill the seat — but she only served briefly, losing a special election to Democrat Mark Kelly in 2020.

Both Fetterman and Casey have issued reassuring statements indicating that they plan to return to work soon.

Joe Calvello, communications director for Fetterman, said in a statement that “He is in good spirits and talking with his staff and family.” He added later that “the results of the MRI, along with the results of all of the other tests the doctors ran, rule out a new stroke.”

Casey, 62, said in a statement, “I can report that I have an excellent prognosis, as well as the benefit of exceptional medical care and the unwavering support of my family. In the coming months I will undergo surgery, after which I am expected to make a full recovery. I am confident that my recommended course of treatment will allow me to continue my service in the 118th Congress with minimal disruption, and I look forward to the work ahead.”

The concern for national Democrats is the party’s slender 51-49 majority in the chamber. A prolonged absence by either Fetterman and/or Casey could place some legislative proposals in jeopardy.

There are strategies available in accordance with rules and precedents to compensate for an absent member according to the Bipartisan Policy Center – unanimous consent, proxy voting and pairs.

Most of the business conducted in the Senate is by unanimous consent, which allows the Senate to operate on the assumption that all members agree to proceed in some manner unless an objection is raised. This prevents all 100 members from having to cast a vote for every action the Senate takes.

Proxy voting is a method used in some legislative chambers that allows absent members to designate another member who can vote on their behalf. Proxy voting is currently not permitted in the Senate for roll call votes, only during committee business.

In the past, when senators have been unable to be present on the floor for several reasons, senators have used a practice called pairing to make sure the member who is not present has their opinion expressed. When pairing, the absent senator will “pair” with a present senator who is on the opposite side of the issue in question. During the roll call vote, the present senator will state that they have paired with a senator who is not in the chamber and will verbally state that if the absent member were there, they would vote in the affirmative or negative on that issue. In turn, the senator in attendance will withhold their vote by voting “present.”

Pairing relies on both precedent and senatorial courtesy. The practice is permitted by Senate precedents, but no senator is required to pair with an absent colleague and, therefore, is extending a courtesy to the absent member.

6 Responses

  1. Endless speculation based on what? You don’t know anything more about it than what the Senators released, but you decide to post an article to provide information or clarification? Nope. Just clickbait.

    1. Considering that Senator Fetterman has returned to the hospital, the information is timely.

  2. It seems Senator Casey’s health issues are common for a man in his 60’s. The ailment can and often is successfully treated and Casey has been very clear about it. Senator Fetterman’s health matters are much more unknown and, unfortunately, persistent. It didn’t take a doctor from John’s Hopkins to determine Sen Fetterman did not look well at the State of the Union address the other day.

        1. Get serious. There are plenty of Dems with real experience. Lamb is light on experience, has done zero for the party and was an invisible representative. No more silver spoon candidates!


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