WASHINGTON — Senate Republicans held the first hearing focused on former President Joe Biden’s health while in office since the announcement of his late-stage prostate cancer diagnosis, as GOP lawmakers hope to dig into what they claim was a cover-up of his decline.

Scrutiny of Biden’s mental state and physical health has been ramped up over the last month after his cancer was revealed to the public and a book included new revelations about the lengths the White House went to accommodate the 82-year-old president.

Wednesday’s hearing is the first dedicated to whether the White House tried to cover up Biden’s decline. Republicans have seized on the accusations about Biden’s mental state, with multiple committees in the House and Senate launching investigations into the matter.

Committee chairs and President Donald Trump have claimed the alleged cover-up of Biden’s decline is a historic scandal.

“There was a conspiracy to hide the president’s true condition by his family, by his staff, by the media and many elected officials,” said Sen. John Cornyn, a Texas Republican. “With a compromised president, our government’s very legitimacy and capacity to function was undermined. The American people paid a price from President Biden’s handling of the border crisis to the disastrous events we saw unfold in Afghanistan.”

Democrats did not call a witness for the hearing and mostly boycotted attending it altogether, with just two Democratic members appearing to make opening statements before leaving.

“The Republican majority on this committee has not held a single oversight hearing despite numerous critical challenges facing the nation that are under our jurisdiction,” said Sen. Dick Durbin, an Illinois Democrat. “Instead of exercising this constitutional oversight duty, my Republican colleagues are holding this hearing. Apparently, armchair diagnosing former President Biden is more important than the issues of grave concern.”

GOP senators said the Democratic boycott of the hearing furthered their case that the party was a part of a destructive cover-up of Biden’s decline while in office.

“The fact that we have none of my Democratic colleagues over here, that this entire diocese is empty, that what they allowed to happen, that they are not interested in correcting it for the future, is absolutely mind-blowing,” said Sen. Katie Britt, an Alabama Republican.

Republicans have also focused on Biden’s use of an “autopen” to sign legislation and executive orders, claiming the former president was not aware of what was being signed using the autopen during his final days in office and that his staffers could have been making decisions on Biden’s behalf.

Trump has charged that Biden’s use of an autopen — a machine used by multiple administrations to sign legal documents — to sign certain documents, such as pre-emptive pardons for lawmakers that investigated the Jan. 6 riot and his family members, could make them invalid.

“Under President Biden, the autopen became a troubling symbol, a symbol of an absentee president in an executive branch directed by nameless, faceless aides that no one outside of Washington, D.C., had ever heard of and no one ever voted for. It was the autopen presidency, a government run by committee rather than a leader chosen by the American people,” said Sen. Eric Schmitt, a Missouri Republican.

Autopens have been used across administrations dating back some two decades, including during Trump’s first term in office and has been considered an acceptable practice by the Justice Department’s Office of Legal Counsel. Multiple Republicans suggested they were considering legislation to either rein in the use of autopens by administrations or implementing guardrails to ensure the president is approving the documents being signed by them.

“The Constitution and the laws generally, when they require that the president act by signing a document, do not require that the president manually sign the document,” John Harrison, a legal scholar at the University of Virginia who served in the Bush and Reagan administrations, said at Wednesday’s hearing.

Multiple committees are examining the use of the autopen in an initiative being spearheaded by the House Oversight Committee, which has requested numerous documents and sought interviews with staffers lawmakers believe were responsible for its use without Biden’s knowledge.

A handful of former Biden White House staff have already agreed to transcribed interviews with the committee over the next month, including former director of the Domestic Policy Council Neera Tanden, former assistant to the president and senior advisor to the first lady Anthony Bernal, former special assistant to the president and deputy director of Oval Office operations Ashley Williams and former assistant to the president and deputy chief of staff Annie Tomasini.

Trump has directed his administration to investigate “whether certain individuals conspired to deceive the public about Biden’s mental state and unconstitutionally exercise the authorities and responsibilities of the President.”

Biden has pushed back on claims Trump and others have been making about his mental state while in office.

“Let me be clear: I made the decisions during my presidency. I made the decisions about the pardons, executive orders, legislation, and proclamations. Any suggestion that I didn’t is ridiculous and false,” Biden said in a statement after Trump’s order was announced.

Wednesday’s hearing directed little focus on Biden’s cancer diagnosis, though its announcement helped prompt a renewal of scrutiny around the former president’s health while in office. Many lawmakers question how the late-stage prostate cancer wasn’t detected sooner, given Biden’s position as president and access to top-notch healthcare. Some committees have sought testimony from Biden’s White House physician, Dr. Kevin O’Connor, who has been scrutinized about why Biden wasn’t receiving regular screening.

Some physicians have said the president should have been screened during his time in the White House, though Biden was in office beyond the age where medical groups generally stop recommending blood tests that catch it due to false positives and overtreatment of low-risk forms of prostate cancer.

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