Rep. Mark Meadows (R-NC) on Monday was elected chair of the House Freedom Caucus, putting him in charge of a group of about 40 stringently anti-choice lawmakers determined to push the GOP further to the right as the party prepares to dismantle the Affordable Care Act (ACA).

Meadows’ takeover marks the Freedom Caucus’s first transition in leadership since it was formed in early 2015.

The group was previously led by Rep. Jim Jordan (R-OH), who vehemently opposes LGBTQ equality and abortion rights. Jordan has introduced anti-choice bills such as the the failed Life at Conception Act, an extreme “personhood” bill that would criminalize abortion and some forms of birth control by defining fertilized eggs, zygotes, embryos, and fetuses as “persons” with full legal protection. Jordan has backed legislation to force doctors to perform an ultrasound while providing graphic details about it before a person can receive abortion care.

Jordan will remain a member of the Freedom Caucus’s leadership, acting as chairman emeritus, according to a Monday report from Roll Call.

Like his predecessor, Meadows has worked tirelessly to roll back access to reproductive health care. He co-sponsored measures such as the U.S. House of Representatives’ medically and scientifically unsupported fetal pain bill and the Prenatal Nondiscrimination Act of 2016—legislation banning sex-selective or race-selective abortions though there is no proof it is a widespread issue in the United States. Reproductive rights advocates say the legislation perpetuates harmful stereotypes about women of color.

Meadows has relentlessly attacked Planned Parenthood, pushing for the organization to be defunded even if that meant shutting down the federal government to get his way. He participated in a sham House Oversight and Government Reform Committee hearing into Planned Parenthood in September 2015 that was used to push misinformation about the health-care organization.

Meadows told Politico this week that the GOP’s tentative plan to repeal the ACA and gradually replace it “will meet with major resistance from Freedom Caucus members.” He told the outlet this would be “the first big fight I see coming for the Freedom Caucus,” and that the ACA “should be repealed and replaced, and all of that should be done in the 115th Congress.” 

Meadows in a 2014 House committee meeting on the ACA demanded a pregnant witness working for the Center for Medicare and Medicaid Services explain why “you have to buy maternity [care], even though you may never have a child,” according to a report from ThinkProgress.