Updated July 11, 2026 at 3:00 AM MDT
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It has been nearly a month since Sen. Mitch McConnell was hospitalized. The retiring Kentucky Republican has not been seen in public since, and his office has offered few details about why he was admitted or when he might return.
This is not the first time this year a member of Congress has been absent for weeks with little explanation, recharging a perennial debate on Capitol Hill over what lawmakers and others in positions of power owe the public when it comes to transparency about their health or fitness for office.
When McConnell was hospitalized in June, Rep. Tom Kean had already been missing from Congress for months. His office shared almost nothing about where he was.
When the New Jersey Republican finally returned at the end of June after nearly four months, he disclosed that he had been in the hospital receiving treatment for depression.
"I was still trying to understand what was happening myself," Kean said on the House floor. "When I said I hoped to return in a matter of weeks, I believed it. As the over 48 million of my fellow Americans being treated for this illness have come to discover, there is no timeline for healing."
That explanation has not satisfied some colleagues and constituents.
"As someone who has lived with depression, I have deep sympathy for anyone struggling with mental illness," Rep. Ritchie Torres, D-N.Y. wrote on X. "At the same time, public office carries a duty of transparency … The public is often most forgiving of those who level with them."
Kean's office said he remained engaged in congressional business during his absence. McConnell's team has said much the same. Several top Republicans reported having phone calls with McConnell on Tuesday.
A spokesman for McConnell's successor, Senate Majority Leader John Thune, R-S.D., said the two men "had a lengthy and substantive conversation that covered a variety of topics, including national security."
What do lawmakers owe the public?
Veteran Capitol Hill staffer Adam Jentleson says all this sparks a sometimes complicated and uncomfortable question: where does the public's right to know begin and the lawmakers' right to privacy end?
"Certainly your ability to serve your constituents — or not — is a very valid point that needs to be addressed," he says.
Jentleson served as communications director for the late former Senate Majority Leader Harry Reid, D-Nev., when he sustained a bad eye injury while exercising. Later, Jentleson was Sen. John Fetterman's chief of staff when the Pennsylvania Democrat checked into the hospital for depression.
In both cases, the lawmakers opted for transparency. Jentleson asserts that did not remain the case for Fetterman as time went on. Jentleson raised concerns that his former boss abandoned his treatment plan and was behaving in ways that would make him unfit to serve. Fetterman has disputed those claims and has accused Jentleson of having a grudge.
In Washington, transparency is often not the first instinct.
Dr. Robert Krasner, a former attending physician to Congress, says that was the case when he diagnosed then-Supreme Court Justice Sandra Day O'Connor with breast cancer.
"At first she said, I don't want anyone to know about this," Krasner said in a 2021 interview with public access station CUNY-TV. "I said, 'That's impossible. I can't fix that in my little office here in the Capitol.'"
Krasner said he encouraged O'Connor to use her own experience to help others. She followed his advice.
"And for years, she would come into my office and show me letters from people who followed her advice to be screened for breast cancer," Krasner said.
Why Congress is hard to walk away from
But these decisions become more complicated when health issues may affect the long-term ability of a lawmaker, judge or president to do the job.
Justices William Brennan and Thurgood Marshall asked Krasner to tell them when it was time to step aside. Krasner has said he could be truthful with them in a way that clerks, the other justices or even their spouses could not.
"In many ways, I was the person they could talk to without any political repercussions," Krasner told CUNY-TV. "And that was a big deal for them."
A doctor willing to be candid and a patient willing to receive the advice – this is not a system. Krasner believes that is a problem and has been pitching more formal mechanisms to help top public officials make that determination.
Many politicians stay in office well into their eighties. Then-President Joe Biden and President Donald Trump both faced questions about their acuity for office. Top Biden aides have been accused of downplaying concerns about his health, especially after a disastrous debate resulted in the end of his reelection bid in 2024.
On Capitol Hill, then-Sen. Dianne Feinstein, D-Calif., became a high-profile example of a lawmaker who declined to step aside even amid mounting questions about their ability to function in the role. She died in office in 2023 at age 90.
Jentleson says lawmakers can be reluctant to give up life in Congress. Lawmakers have staff to drive them around, plan their travel and bring their meals, as well as an attending physician down the hall and intellectual stimulation on interesting topics.
"It mimics a lot of the aspects of a senior living facility, so it is hard to walk away from," Jentleson says.
This term, five members of Congress died in office. In an extreme example, the office of then-Rep. Kay Granger, R-Texas, did not disclose her move to an actual senior living facility. Her son told the Dallas Morning News in 2024 shortly before she retired that she had been experiencing "dementia issues."
Jentleson says members need to retire at a point when they probably could still continue to serve or win their next race. Otherwise, they may end up either unable to make that decision or with a legacy tainted by a diminished final chapter. When they do not, Jentleson says it can be hard for staff to speak up.
"For me, where the line comes in is when it is a question of capacity and ability to make judgement calls," Jentleson says. "If that judgement is impaired … I think the public has a right to know. And then the public can do whatever they want with that information," he says.
How lack of transparency erodes public trust
The litany of examples of officials not being forthright about health erodes trust in the institution, says Adam Enders, a University of Louisville political science professor who studies conspiracy theories. He says this is one reason the information void around McConnell and Kean sparked so many of them.
There is a "truthiness," as Stephen Colbert's character on the Colbert Report used to say, or nugget of truth to this idea of politicians not being fully open about their health.
Enders sees these conspiracies as less nefarious than other claims, like misinformation about stolen elections. Though he says there is a fine line between conspiracy theories designed to advance an agenda versus the kind of skepticism that can be healthy in a democracy.
"It's not the worst thing in the world to have citizens that are monitoring the people who they've turned power to and hoping they're doing the kinds of things they're elected to do," Enders says.
Extended absences can have consequences, especially in a narrowly divided Congress. Kean and McConnell both missed crucial votes – including on Iran war powers resolutions that barely passed.
Rep. Jamie Raskin, who has authored legislation to address what he sees as gaps in the 25th amendment, which addresses scenarios where the president cannot discharge the duties of office, says the risks to the nation are lower for an individual member of Congress compared to the president.
The Maryland Democrat has thought a lot about health, transparency and public service. He says sharing his 2022 cancer diagnosis was an easy decision, but recognizes that is not the case for everyone.
"I don't know that you can say there's one right way of dealing with it," Raskin says. "I felt my constituents had a right to know. I wanted to have that transparency. And I think it also gave me a tremendous amount of support."
Copyright 2026 NPR
