Robert Wilkie, a Pentagon under secretary, was confirmed Monday by the Senate as secretary of the Department of Veterans Affairs, giving the sprawling agency its first permanent leader in months.
The vote, which was 86-9, came the day before the President will address the Veterans of Foreign Wars national convention in Kansas City.
Nominees to lead the VA are typically confirmed unanimously by the Senate. While Wilkie was confirmed overwhelmingly, the vote was the first time since the VA secretary became a Cabinet position that any senators voted against confirmation.
In a statement, President Donald Trump praised Wilkie as someone who has "dedicated his life to serving his country with honor and pride," and said Wilkie has displayed "great patriotism and a commitment to supporting and empowering America's armed forces and veterans."
The nine lawmakers who voted against Wilkie's nomination were mostly Democrats, joined by Bernie Sanders, a Vermont independent, who cast the lone dissenting vote against advancing Wilkie's nomination in committee. Sanders said then that he voted no because he was concerned that the Trump administration would privatize the VA's health care.
Sens. Kirsten Gillibrand of New York, Kamala Harris and Dianne Feinstein of California, Ron Wyden and Jeff Merkley of Oregon, Cory Booker of New Jersey, and Elizabeth Warren and Ed Markey of Massachusetts all voted no.
Wilkie's confirmation to lead the federal government's second largest department came as the agency had remained without a Senate-confirmed leader for months, after Trump ousted then-Secretary David Shulkin in March and sought to replace him with Rear Adm. Ronny Jackson, a White House physician. Jackson ultimately withdrew from consideration after allegations of misconduct during his time at the White House Medical Unit, and Trump named Wilkie as the agency's acting secretary.
When Trump announced Wilkie's nomination to take the reins permanently in May, he left the agency and acting Secretary Peter O'Rourke took over, overseeing the VA's workforce of more than 360,000.
Sen. Johnny Isakson, who chairs the Senate's veterans panel, said Wilkie is the "real deal."
"We know the things that we've gone through with some of the previous appointees, and some of the problems at the VA now have a chance to be overridden and solved, and we'll step forward with a new day for the VA," the Georgia Republican said Monday. "We no longer want someone who's going to make excuses for the VA. We want someone who is going to make a difference."
During his confirmation hearing, Wilkie, who served as an assistant defense secretary in the George W. Bush administration, pledged not to privatize health care for the nation's veterans, and indicated that if confirmed he would not shy away from disagreeing with the President.
Veterans' groups and some lawmakers have said they worry that the Trump administration wants to widely expand the private care that veterans receive, a move that they believe would dismantle the VA's health care system.
Wilkie inherits an agency beset with challenges, including high-level turnover. The Washington Post reported last week that a number of longtime career employees have left the agency, and some critics have raised concerns that politics may have played a role in the departures.
Agency officials have denied that politics were involved, saying unequivocally that staffers have not been pushed out for political reasons.
"This has understandably shaken up VA's Washington bureaucracy," VA spokesman Curt Cashour said last week. "And in many cases, employees who were wedded to the status quo and not on board with this administration's policies have departed VA -- some willingly, some against their will as they were about to be fired."
Montana's Sen. Jon Tester, the Senate veterans committee ranking member, said Monday that there were "political forces at play" in the agency, and that Wilkie had a responsibility to ensure that good employees weren't being forced out due to their political views.
"We've had temporary political appointees in charge," Tester said. "They're more interested in picking political fights with people who are not their enemy. I believe we've lost sight of the VA mission. It will be up to Mr. Wilkie to right that ship."
This story has been updated with additional developments.