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Cawthorn has said, "Helping Western North Carolina emerge from this once-in-a-century pandemic will be my top priority in Congress." He has also said that in reopening, "We need to be guided by science and common sense, not politics." Cawthorn has criticized aspects of the CARES Act, saying that, "I don't think it gave the money or exactly where it needed to be put ... I think that we should have focused more on giving money to small business owners so that we can keep people getting their paychecks from their employers instead of relying on unemployment."
Cawthorn wants to see the ACA repealed and replaced with a free market approach to health care, saying, "The problem is not that the free market has failed in health care. The problem is that it has never really been tried."
Cawthorn supports federal legalization of medical and recreational marijuana, though he believes states should be allowed to choose to criminalize it. Cawthorn has received an A rating from NORML.
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Cawthorn is pro-life. He is a supporter of the Born Alive Abortion Survivors Protection Act and opposes funding for Planned Parenthood from any level of government.
When he was 18, Cawthorn was involved in a car accident that left him paralyzed and using a wheelchair. He has stated that the accident left him with over $3 million in medical debt.