Georgia House Speaker David Ralston is stepping down as speaker at the end of the this year, he announced Friday, citing health concerns.

The Republican has been speaker since 2010. He was first elected to the state House of Representatives in 2002.

A lawyer from Blue Ridge in the north Georgia mountains, Ralston said he hopes to continue as a member of the House if his health concerns can be resolved. Ralston is unopposed for reelection.

Ralston’s decision not to run for another term as speaker could set up a struggle for leadership in the lower chamber. Republicans currently hold a 103-76 majority in Georgia’s House, with one seat vacant after an Augusta Democrat died.

The GOP is favored to maintain control, but could come back with a narrower majority after Tuesday.

That’s important because legislation requires 91 votes to pass in the chamber, not just a majority of those present and voting.

The speaker assigns bills to committees, controls the flow of legislation on the floor while presiding over House sessions and is the House’s chief administrative officer. But, in reality, Ralston’s power has been far greater.

He has been the unchallenged leader of the House and has the power to shape legislation to his preferences, as he displayed earlier this year while muscling through a major reform of how mental health benefits are provided by private insurers and how the state handles provision of mental health.