The Washington PostDemocracy Dies in Darkness

Shulkin unanimously confirmed to head Veterans Affairs

David Shulkin, testifies on Capitol Hill in Washington, Wednesday, Feb. 1, 2017, at his confirmation hearing before the Senate Veterans' Affairs Committee. (Alex Brandon/AP)

David J. Shulkin, an internist and longtime health administrator, was unanimously confirmed Monday to lead the troubled Veterans Affairs Department, becoming the first of President Trump’s Cabinet picks to be embraced by all Republicans and Democrats. He is the sole holdover from the Obama administration.

No senators dissented on Shulkin’s nomination in a rare show of bipartisanship following contentious battles over other Trump Cabinet selections. Shulkin’s approval makes him the 11th high-ranking Trump official to be confirmed by the Senate.

Your complete guide to Trump’s Cabinet confirmation schedule

The 57-year-old Pennsylvania native will run the second-largest federal agency after serving 18 months as undersecretary for health in charge of VA’s sprawling medical system, which takes care of nearly 9 million veterans a year. After a long search for a leader who could turn around a system Trump denounced on the campaign trail as a tragic failure, the president surprised critics by turning inside rather than outside for a VA leader.

Just before the vote, the leading lawmakers on the Senate Veterans’ Affairs Committee urged their colleagues to put aside the partisanship that has defined the confirmation battles so far.

“Let’s find out if there’s one thing we can agree on,” said Sen. Johnny Isakson (R-Ga.), the committee chairman.

Anticipating critics nervous that the Trump administration will turn VA over to the private sector, Isakson said, “We don’t want to privatize VA. We want to make it work.”

Shulkin will be the first secretary who did not serve in the military, a status that has disappointed some veterans groups but did not disqualify him from what proved to be one of Trump’s most difficult Cabinet searches.

Despite his relatively quick and trouble-free nod from lawmakers, Shulkin has a tall order from the president. He needs to show Trump that he can bring big changes to VA to make employees more accountable for misconduct and give veterans faster access to private doctors when they prefer outside care.

Shulkin will oversee 350,000 employees, an $82 billion budget and almost 2,000 clinics and medical centers that are overwhelmed with demands for care from aging Vietnam veterans and younger service members who fought in Iraq and Afghanistan.

Shulkin faces drastic shortages in frontline nurses and doctors: About 45,000 medical jobs throughout the system are unfilled. Groups that advocate for veterans are on high alert three years after a wait-time scandal in which managers ordered their staffs to cover up delays in appointments at dozens of medical centers.

With Trump and other critics calling for a shift to more private care outside VA, Shulkin will be under pressure to loosen the reins of a system that limits private doctors to veterans who live too far from a VA hospital or could not get timely appointments there.

Traditional veterans group have resisted calls for more private care. But Trump said during his campaign that he would give a credit card to every veteran who wanted to see a private doctor.

Shulkin said during his confirmation hearing this month that he would seek “major reform and a transformation of VA” — but would not turn over vast parts of the federal health-care system to private doctors.

"There will be far greater accountability, dramatically improved access, responsiveness and expanded care option," Shulkin told lawmakers on the Senate Veterans' Affairs Committee. "But the Department of Veterans Affairs will not be privatized under my watch."

Republicans have pressed Shulkin for assurances that he will act swiftly to winnow a growing backlog in appeals of denied benefit claims. The new secretary has acknowledged the benefit appeals system as a “broken process,” largely because VA relies on outdated technology.

Shulkin came to government with three decades of experience in patient care and leading private hospitals. The son of an Army psychiatrist, he was born on an Army base and trained at VA hospitals.