Sen. Johnny Isakson (R-Ga.) said Wednesday that he will resign at the end of 2019 because of health problems, setting the stage for two competitive Senate races in Georgia in a presidential election year.

Isakson, who was reelected to a third term in 2016, said in a statement that he had informed Georgia Gov. Brian Kemp (R) of his decision to leave “a job I love because my health challenges are taking their toll on me, my family and my staff.”

His resignation is effective Dec. 31.

“My Parkinson’s has been progressing, and I am continuing physical therapy to recover from a fall in July. In addition, this week I had surgery to remove a growth on my kidney,” the 74-year-old senator said.

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Isakson was hospitalized last month with four fractured ribs and a torn rotator cuff after a fall at his Washington apartment. On Monday, he had surgery in Georgia to remove a two-centimeter renal cell carcinoma from one of his kidneys, his office said.

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Kemp is expected to tap a Republican to replace Isakson next year. His retirement means Georgia voters will be asked to choose two U.S. senators next year, as Sen. David Perdue (R) is seeking a second term. Republicans hold a 53-47 majority in the Senate, and Isakson’s planned retirement means they will have to defend another seat next year in addition to the 22 GOP contests on the ballot. Democrats have 12 seats up for reelection.

In a statement, Kemp thanked Isakson for his years of service and said he will appoint a successor “at the appropriate time.”

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“Senator Isakson’s list of accomplishments on behalf of the state that he loves is long and revered, but what Georgia should be most thankful for is the high standard that Johnny held as a true gentleman, a fighter for his constituents, a trusted advocate for our nation’s veterans, and one of the greatest statesmen to ever answer the call of service to our country,” Kemp said.

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Isakson’s departure immediately shifted attention to Democrat Stacey Abrams, who narrowly lost the governor’s race in 2018. Abrams said in a statement she will not seek the seat, but she is likely to face continued pleas from Democrats to run.

“Our thoughts are with Senator Isakson and his family,” Abrams spokesman Seth Bringman said. “Leader Abrams’ focus will not change: she will lead voter protection efforts in key states across the country, and make sure Democrats are successful in Georgia in 2020. While she will not be a candidate herself, she is committed to helping Democratic candidates win both Senate races next year.”

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Democrats had previously courted Abrams to challenge Perdue, but she turned them down and has focused on building a national voter protection program.

In a statement issued after his release from the hospital last month, Isakson’s office said that symptoms of his Parkinson’s disease could lengthen the recovery process. Isakson revealed in 2015 that he had received a diagnosis of Parkinson’s two years earlier, saying that he experienced stiffness in his left arm and a slower gait as a result of the condition.

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Isakson is chairman of the Senate Committee on Veterans Affairs and the Senate Select Committee on Ethics.

Isakson was set to serve through the 2022 election. Under Georgia law, according to the National Conference of State Legislatures, Kemp will make an appointment to replace Isakson pending a special election to be held concurrently with the 2020 general election.

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Possible Republican replacements include Georgia Attorney General Chris Carr, who served as chief of staff to Isakson; Lt. Gov. Geoff Duncan; and U.S. Rep. Douglas A. Collins.

The winner of the 2020 election will serve the remaining two years of Isakson’s term, and the winner of the 2022 election will serve a full six-year term.

Isakson is the fifth senator to announce plans to retire. Three other GOP committee chairmen — Pat Roberts (Kan.), Lamar Alexander (Tenn.) and Mike Enzi (Wyo.) — have said they will not seek reelection next year, depriving the Senate of some of the more powerful pragmatic conservatives who have worked closely with Democrats to advance bipartisan legislation.

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Sen. Tom Udall (N.M.) is the lone Democrat not seeking another term.

Stewart Boss, a spokesman for the Democratic Senatorial Campaign Committee, said in a statement that Isakson’s seat is “yet another seat Republicans will need to defend next year in an increasingly competitive battleground where the president’s approval has plunged by double digits since taking office.”

News of Isakson’s retirement prompted praise for the senator from both sides of the aisle.

“One of the many fine adjectives to describe Johnny Isakson is a word not used enough in the halls of Congress these days: kind,” Senate Minority Leader Charles E. Schumer (D-N.Y.) said in a statement. “Not only is Johnny a diligent and successful legislator, he is one of the kindest, most thoughtful senators. Independent of any party or politics, everyone will miss Johnny.”

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Senate Majority Leader Mitch McConnell (R-Ky.) called Isakson “not only a first-rate legislator but also a man of the highest integrity.”

“His humor, humility, and enduring faith have made him a role model to all of us who have had the pleasure to work with him,” McConnell said.

And Sen. Todd C. Young (R-Ind.), chairman of the National Republican Senatorial Committee, called Isakson “a steadfast conservative leader who has served Georgians with the highest integrity and distinction in the U.S. Senate.”

“He will be missed, but we look forward to the men and women of Georgia electing another strong Republican leader in 2020 alongside David Perdue,” he said.

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With Isakson’s retirement, Democrats now must field two Senate candidates in Georgia, a state that has been trending slowly in their direction but so far has remained out of grasp in statewide races.

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The dynamics were inverted last year in Minnesota, where Republicans had to field candidates against Democratic Sens. Amy Klobuchar, a two-term incumbent, and Tina Smith, who had been appointed to replace Al Franken after his resignation. The GOP poured the bulk of its resources into the race against Smith, who was seen as the far weaker candidate. Smith ultimately won by 10 points, while Klobuchar won by 24 points.

It’s unclear whether Democrats, who have viewed Perdue as vulnerable to a strong challenge, would engage in a similar game of triage.Five Democrats have declared campaigns to challenge Perdue; so far only Teresa Tomlinson, the former mayor of Columbus, has raised a significant amount of money, indicating a credible campaign.

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Other candidates include Clarkston Mayor Ted Terry, who appeared last year in an episode of the Netflix reality show “Queer Eye,” and Sarah Riggs Amico, a business executive who ran for lieutenant governor last year. Both Terry and Amico signaled Wednesday that they would stay in the race against Perdue.

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Another potential candidate is Jon Ossoff, who was a liberal political star in 2017 when he made a strong but unsuccessful bid in a special election for the 6th Congressional District seat in suburban Atlanta.

Nikema Williams, chairman of Georgia Democratic Party, said in a statement: “We thank Senator Isakson for his years of service to his state and country, and wish him all the best for his future.”

“With now two Senate seats up for election in 2020, it has never been clearer that the path for Democratic victory runs through Georgia,” Williams added. “We are the battleground state, and Georgia Democrats are ready to fight and deliver both the Senate and the presidency for Democrats across the country in 2020.”

Before entering politics, Isakson worked for a real estate firm, Northside Realty, that his father helped to found. Isakson became its president in 1979 and led the company for two decades, during which time it grew to become one of the country’s largest independent real estate brokerages.

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Isakson’s political career began with his election to the Georgia House in 1976. He is the only person in Georgia’s history to have been elected to the state House and U.S. House and Senate.

“In my 40 years in elected office, I have always put my constituents and my state of Georgia first,” Isakson said in his statement. “With the mounting health challenges I am facing, I have concluded that I will not be able to do the job over the long term in the manner the citizens of Georgia deserve.”

“It goes against every fiber of my being to leave in the middle of my Senate term,” he added, “but I know it’s the right thing to do on behalf of my state.”