Senate Republican Leader Mitch McConnell’s (R-Ky.) health scare has Republican senators wondering whether the 81-year-old lawmaker will stay in the top job beyond the 2024 election and who might eventually replace him.  

McConnell plans to serve out his current term as leader and has given every indication that he intends to return as Senate GOP leader in the 119th Congress, which starts in January of 2025 — hopefully from his point of view with Republicans in control of the Senate majority.  

Yet Republican senators privately acknowledge that McConnell appears to be frailer since falling and suffering a concussion on March 9, which resulted in him being hospitalized for several days. The accident required rehabilitation at an inpatient facility and kept him away from the Capitol for more than a month.  

McConnell’s health came back into the spotlight Wednesday when he froze midsentence while delivering his opening remarks at the weekly Republican leadership press conference and had to step away from the podium and return to his office for a few minutes to recover.  

He later insisted that he was “fine” and declined to comment specifically about any health problems he may have, leaving GOP colleagues to speculate about how much longer he will serve as leader and who has the inside track to replace him. 

“I think the leadership race is well underway and this accelerates that,” said a Republican senator who requested anonymity to discuss the fallout from McConnell’s health episode before television cameras Wednesday.  

The lawmaker noted that Senate Republican Whip John Thune (R-S.D.) ran the Senate floor this month during the debate and votes on the annual defense authorization bill, with his staff working in close coordination with floor staff to get agreements on amendments and resolve objections.  

“Thune is running the floor, he’s running the [National Defense Authorization Act] negotiations,” the lawmaker said. 

Thune helped get 80 amendments adopted to the defense bill — through the manager's package, roll call votes and voice votes — helping GOP colleagues ring up accomplishments.

The senator said the shadow race to one day replace McConnell has boiled down to Thune, Sen. John Cornyn (Texas), who previously served as Senate GOP whip, and Senate Republican Conference Chairman John Barrasso (Wyo.).  

“Cornyn has been very solicitous” about raising money for Republican senators who are up for reelection next year, showcasing his fundraising ability, which has been one of McConnell’s greatest strengths as leader, the senator said.  

Cornyn’s joint fundraising committee, the Cornyn Victory Committee, has raised $4.12 million for Senate GOP incumbents, future Senate GOP nominees and the National Republican Senatorial Committee (NRSC) through the first six months of this year.  

Cornyn raised a total of $20 million for Senate Republican candidates in the 2022 election cycle, more than any other Republican senator with the exception of McConnell and then-NRSC Chairman Rick Scott (R-Fla.).  

“We hope to exceed that,” Cornyn said of what he plans to do for the 2024 election compared to the $20 million he raised for candidates in the 2022 election cycle. 

“Historically, I used to just raise money for the senatorial committee and let them spend it the way they saw fit, but I found that colleagues appreciate the [direct] help,” he said. “It saves them their wear and tear and a little time so they can hopefully maximize their fundraising elsewhere.” 

McConnell continues to be a major force in fundraising and any successor would have big shoes to fill in that area. 

Two outside groups aligned with McConnell, the Senate Leadership Fund and One Nation, raised a combined $38 million during the first six months of 2023, setting a record for the first half of a nonelection year. 

Republican senators say they view Thune, who is 62, and Cornyn, 71, as the front-runners to become the next Senate GOP leader.  

“I think those will be the two that run for leader when that happens,” said a second Republican senator who requested anonymity to discuss the brewing succession battle.

The senator said “Cornyn’s been raising money for people for years” and has built a solid record as a major GOP fundraiser while pointing out it’s Thune’s “job” as whip to be managing the daily developments on the Senate floor.  

“I’m glad that he stepped up” during the floor consideration of the defense bill, the senator said, which came close to derailing because of an ongoing dispute over the Pentagon’s policy of paying for servicemembers to travel to obtain abortions.  

The senator said neither Thune nor Cornyn have said anything about running for McConnell’s job. But their ambitions to move up to the top job are an open secret.  

“The leadership is interesting times,” the senator remarked, noting that Thune and Cornyn “can’t discuss” their plans because it would be “rude” while McConnell is in the job.

Senators say Barrasso, 71, can’t be ruled out of the mix because he plays an important role as GOP conference chairman in pushing messaging strategy and could run as a more conservative alternative to Thune and Cornyn in a three-way race.

Barrasso, for example, voted against this year’s debt limit deal between Speaker Kevin McCarthy (R-Calif.) and President Biden, which other members of the Senate GOP leadership supported. 

Former NRSC Chairman Rick Scott (R-Fla.), who is up for reelection next year, hasn’t ruled out another run for Senate Republican leader.  

He challenged McConnell in November in what became an intense and sometimes acrimonious debate over the future of the GOP conference before losing by a vote of 36-10. 

A Senate Republican aide said Cornyn has had to be more aggressive in angling for a future opening for Senate leader because he does not currently hold a position in the elected leadership. He had to step down as whip because of term limits in January of 2019.

“Thune and Cornyn are the two names that have been in the mix the most because they have both been whip, and everybody knows that Cornyn wants the [leader’s] job more than anything,” the aide said.  

Cornyn has held regular lunches and coffees with fellow Republican senators to help maintain his relationships with colleagues.  

He has kept ties with the conservative wing of the GOP conference by regularly attending Monday evening meetings of the Senate Republican Steering Committee. 

Thune and Cornyn have both publicly expressed interest in becoming leader in the future but have also made clear that the job is McConnell’s for as long as he wants it.  

Thune earlier this year waved off a question about running for Senate Republican leader as putting “the cart before the horse.”  

He stepped in to handle some of McConnell’s responsibilities, such as leading the weekly leadership press conference, while McConnell underwent rehabilitation after his fall.

Likewise, Cornyn this week insisted to reporters that he isn’t actively running to become the next leader. 

“There’s no vacancies,” he said. “And those [leadership] elections won’t be until November 2024. So I guess the short answer is there’s nothing to prepare for.”  

Barrasso has only said he would like to continue serving the Senate GOP conference in whatever way is most helpful to his colleagues.  

The Wyoming doctor was in the spotlight himself Wednesday because he came to McConnell’s aid after he froze in the middle of delivering his opening remarks at the press conference.  

Barrasso acknowledged to reporters immediately afterward that he was “concerned” about McConnell’s health since his accident in March but hastened to emphasize “he’s made a remarkable recovery” and is “doing a great job leading our conference.” 

Some Republican senators downplayed the incident, which McConnell’s office attributed to the leader feeling “lightheaded,” as a blip that doesn’t affect his ability to lead the conference.  

“Naturally, anytime it happens I think you’re concerned, but in terms of his capabilities and ability to lead, no, I’m not worried about his ability to lead,” said Sen. Mike Rounds (R-S.D.).  

A third Republican senator who requested anonymity, however, said that some GOP senators feel they aren’t getting the full story about McConnell’s health, which is in turn fueling speculation about how much longer he will remain leader. 

“No one says what’s wrong with him,” the senator said. “I think there ought to be more transparency here.”  

Al Weaver contributed.  

--Updated at 8:00 a.m.