The Senate voted to clear Seema Verma to lead the Centers for Medicare and Medicaid Services under President Trump.
Verma was confirmed in a 55-43 vote Monday evening.
She will now be dropped into the fight over how to repeal and replace the Affordable Care Act and is expected to play a large role in any attempt to reform either Medicare or Medicaid.
Her confirmation vote comes the same day as the Congressional Budget Office (CBO) released its long-awaited analysis of the Republican ObamaCare replacement bill.
The report finds that the 24 million people would become uninsured by 2026 largely due to the proposed changes in Medicaid. The bill both ends the extra federal funds for the expansion of Medicaid and caps overall federal spending for the program, both of which CBO says would lead to people losing coverage.
What happens to ObamaCare's Medicaid expansion is a key concern of a handful of Senate Republicans, who have warned they could vote against a repeal bill over the issue. The GOP's bill calls for the rollback of the expansion after 2019.
Democrats largely said they opposed Verma's nomination after trying unsuccessfully to pin her down on a number of policy issues during her confirmation hearing, including if or how she would reform the programs.