President Donald Trump and Senate Majority Leader Mitch McConnell have tried to make it clear: Given the chance, they would push through a Supreme Court nominee should a vacancy occur before Election Day.

The issue has taken on new immediacy with the disclosure Friday that Justice Ruth Bader Ginsburg is receiving chemotherapy for a recurrence of cancer after four earlier bouts with the disease. The 87-year-old liberal, who apologized in 2016 for her pointed public criticism of Trump during his first campaign, says she has no plans to retire.

The development has focused even more on what’s at stake this election, with the winner in position to help shape the trajectory of the court for years to come.

Trump administration officials have underscored that Trump would not hesitate to fill an opening before voters have their say Nov. 3, less than four months away, on whether to give him a second term.

Four years ago, also in a presidential election year, the GOP-controlled Senate refused to hold a hearing or vote when President Barack Obama, a Democrat, nominated federal judge Merrick Garland to succeed Justice Antonin Scalia after his death in February. Nine months before that year’s election, McConnell said voters should determine who would nominate the person to fill that seat.

Fast forward to this past week. Trump’s chief of staff, Mark Meadows, told reporters: “I can’t imagine that if he had a vacancy on the Supreme Court that he would not very quickly make the appointment and look for the Senate to take quick action.”

Meadows spoke shortly after the court said Ginsburg was briefly hospitalized, but before the justice announced she had a recurrence of cancer and has been treated with chemotherapy since May 19.

Ginsburg is the oldest justice, followed by Stephen Breyer, 81, Clarence Thomas, 72, and Samuel Alito, 70.

Trump sees his efforts at reshaping the judiciary as a signature achievement of his presidency. Last month he marked his 200th judicial appointment. Earlier in his term, he won confirmation of Neil Gorsuch and Brett Kavanaugh to the high court.

The president has sought to remind fellow Republicans that should he win a second term, he would have the chance to push the Supreme Court and lower courts further to the right.