Rep. Ronny Jackson, who served as numerous presidents’ White House physician, has submitted a letter to House Republicans urging that President Biden take a cognitive test or drop out of the 2024 election.

Jackson, a Republican from Texas, has led prior campaigns to get Biden to undergo a cognitive test, including one in July 2022 that had the support of more than 50 House Republicans. The latest letter was released as Biden declared Tuesday morning that he would run for reelection, as per Fox News.

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Jackson’s letter to Biden is addressed to him and states, “We call on you to either resign immediately and renounce your bid for reelection or submit to a clinically validated cognitive screening assessment and make those results available to the public.”

Jackson wrote – “When you first announced your bid to run in the 2020 presidential election, questions and concerns were raised surrounding your cognitive abilities. Those concerns have only increased because your mental decline and forgetfulness have become more apparent since you were elected.”

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Jackson added, “The American people should have absolute confidence in their President and know that he or she can perform their duties as Head of State and Commander in Chief. Therefore, the American people deserve complete transparency on the mental capabilities of their highest elected leader.”

Concerns concerning Biden’s mental acuity have often been dismissed by the Biden administration. Attacks on Biden’s suitability for office have historically failed, according to White House press secretary Karine Jean-Pierre, who was speaking earlier this year when GOP presidential contender Nikki Haley suggested requiring officials over 75 to undergo mental competency tests.

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The absence of interviews with press organizations by Biden has further fanned rumors that the White House is being cautious when using Biden in situations where there may be hostility. As of February 8, Biden had given 33 interviews overall while serving as president, according to Mark Knoller, a longtime White House correspondent for CBS. According to Knoller, Obama was at 273 at that point in his presidency while Trump was at 147.