Rep. Tom Kean Jr. (R-N.J.) returned to Congress in June after months of unexplained absence, later revealing he endured a lengthy hospital stay for depression. During his time away, constituents had no formal mechanism to learn why their representative was not serving or to demand answers about the status of his seat.
Similarly, former Senate Majority Leader Mitch McConnell (R-Ky.) spent weeks hospitalized following a fall and subsequent pneumonia before details emerged publicly. Kentucky Gov. Andy Beshear (D) told SiriusXM he received no communication from McConnell's office during the absence, prompting him to send a letter of inquiry about the senator's well-being.
The two cases highlight a gap in congressional succession rules: while the Constitution grants both chambers broad authority over membership, it provides no clear path for removing lawmakers who are incapacitated or absent for extended periods. The silence leaves constituents without representation and elected officials with few tools beyond expulsion, which requires a two-thirds majority vote.
What the Right Is Saying
Conservatives and constitutional scholars who support existing structures argue that removing a seated lawmaker sets a dangerous precedent. They contend that voters elected these individuals for specific terms, and only electors should have the power to replace them through elections or resignation.
Senate Republican sources familiar with internal deliberations said colleagues resisted calls from some quarters for Majority Leader John Thune (R-S.D.) to pressure McConnell to step aside during his hospitalization. One senior Republican aide said pushing out a longtime leader over health concerns would amount to political punishment and deter future candidates from public service if they face medical challenges.
Defenders of the current system argue that House Speaker Mike Johnson (R-La.) appropriately handled Kean's absence by maintaining regular communication with the New Jersey delegation while respecting the congressman's privacy about his treatment.
What the Left Is Saying
Progressive advocates argue that extended absences without transparency undermine voters' right to effective representation. When lawmakers cannot serve, their constituents lose a voice in Congress during critical legislative debates and votes.
Organizations focused on government accountability have called for mandatory disclosure requirements when members face health challenges affecting their ability to work. They argue taxpayers deserve to know why elected officials are not fulfilling their duties.
Some Democratic legislators have proposed rules changes that would require the House or Senate to formally notify a member's state delegation when an absence extends beyond a set period, potentially triggering conversations about temporary replacement options.
What the Numbers Show
The Constitution's Article I, Section 5 grants each chamber the power to judge member qualifications and expel members with two-thirds concurrence. However, nothing in Article I addresses health, mental capacity, or dereliction of duty as grounds for removal.
Historical precedent shows Congress has rarely expelled members for health reasons. The late Sen. Carter Glass (D-Va.) remained on the rolls while absent for four years before his death in 1946 despite calls to resign. His refusal set no formal precedent but demonstrated governors cannot force vacancies without a member's resignation or death.
The Senate did not remove Sen. Karl Mundt (R-S.D.) after a stroke in 1969 left him unable to speak. Republican colleagues requested he step aside, but his wife rejected those entreaties. Mundt served until his term expired in early 1973.
Other lawmakers have faced extended absences due to illness: Rep. Lane Evans (D-Ill.) missed years while battling Parkinson's Disease; Sen. Mark Kirk (R-Ill.) returned after a year-long absence following a 2012 stroke; and Sen. John Fetterman (D-Pa.) was away for approximately two months during depression treatment in 2023.
The Bottom Line
The cases of Kean and McConnell expose an unresolved tension between constituent expectations and constitutional reality. Voters have no formal mechanism to demand answers about prolonged absences, and Congress has limited tools beyond expulsion or waiting for natural term expiration.
No legislation currently pending would establish clear protocols for temporary replacement when health prevents a member from serving. Any such change would require action by the House or Senate adopting new internal rules, which would need support from members who may one day face similar circumstances themselves.
What remains unclear is whether recent high-profile absences will generate momentum for reform, or simply fade as another example of congressional self-governance operating without external accountability.