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(WASHINGTON) — The Senate is set for an uncertain and busy return from its August recess Tuesday, with Senate Minority Leader Mitch McConnell’s health in question and a stocked to-do list looming.

The longtime GOP leader last week appeared to freeze for more than 30 seconds while giving remarks in Kentucky. The incident added to concerns that were sparked in late July when the 81-year-old was escorted away by colleagues from a press conference on Capitol Hill after he stopped speaking mid-sentence.

He stayed to answer another question last week, while in July he eventually returned to answer more questions from the press after he was helped away.

McConnell’s office attributed the latest freeze to lightheadedness and released a letter Thursday from Dr. Brian P. Monahan, the Capitol attending physician, who said he had consulted with McConnell and McConnell’s neurology team and that the Republican leader is medically clear to continue with his schedule.

Monahan did not say he personally examined McConnell.

“… I have informed Leader McConnell that he is medically clear to continue with his schedule as planned,” Monahan said. “Occasional lightheadedness is not uncommon in concussion recovery and can also be expected as a result of dehydration.”

McConnell’s health has been a source of concern and speculation since he suffered a concussion and a broken rib after a fall in Washington earlier this year. He underwent inpatient rehabilitation after a dayslong hospital stay.

The GOP leader’s allies have come out in support after his second freeze, insisting the Kentuckian is up to the task of leading his party in the Senate.

“Mitch is sharp, and he is shrewd. He understands what needs to be done,” South Dakota Sen. Mike Rounds said Sunday on CNN. “I will leave it up to him as to how he wants to discuss that with the American public. But there’s no doubt in my mind that he is perfectly capable of continuing on at this stage of the game.”

Sen. Susan Collins, R-Maine, wrote Thursday on X, the platform formerly known as Twitter, that McConnell is “fully prepared to continue leading our caucus when the Senate resumes session on Tuesday.”

Even President Joe Biden, who often finds himself on the other end of the negotiating table from McConnell but formed a decadeslong relationship with him while in the Senate, expressed confidence that McConnell would be able to execute his job.

“I spoke to him today,” Biden told reporters Thursday. “He was his old self on the telephone.”

Asked if he harbored concerns about McConnell’s ability to serve as GOP leader, Biden responded, “No, I don’t.”

Still, other Republicans continue to have concerns regarding the freeze episodes.

Former South Carolina Gov. Nikki Haley, who is running for the GOP presidential nomination and has already called for competency tests for leaders over 75 years old, pointed to McConnell and other ailing lawmakers like Sen. Dianne Feinstein to argue that Congress’ old guard should consider stepping aside.

“At what point do they get it’s time to leave?” Haley said on CBS News. “They need to let a younger generation take over. We want to go and start working for our kids to make sure we have a strong national security, to make sure we have a stronger economic policy, to make sure that America is safe.”

Fellow GOP presidential candidate Vivek Ramaswamy said Friday that he thought it would be “most prudent if he stepped aside.”

The speculation over McConnell’s health is taking place amid fierce debates over government spending and aide to Ukraine.

Government funding runs out at the end of the month, and Congress will need to either pass a new budget or a continuing resolution, a short-term patch that would extend government funding at current levels.

Prior to the August recess, senators marked up legislation that largely mirrors the budget caps agreed to by Biden and House Speaker Kevin McCarthy, R-Calif., earlier this year. However, the GOP-controlled House pushed legislation far beneath those levels.

Among the major dividing lines among Republicans is aide to Ukraine, with more traditional lawmakers, including McConnell, urging more weapons and resources go to Kyiv and more populist lawmakers suggesting Washington roll back its support.

Some hardline House Republicans have also threatened to vote against a government funding bill if it doesn’t include funding for their own investigations into the Biden administration or remove funding from special counsel Jack Smith’s probes into former President Donald Trump, language that would likely have trouble getting passed in the Democratic-controlled Senate.

“My guess is we will have a lot of screaming and shouting, and we’ll end up shutting down the government,” Sen. Mitt Romney, R-Utah, said last week. “And a lot of people will be inconvenienced or hurt as a result of doing that. But we’ll do it.”

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