President Trump’s pick to run Medicare and Medicaid won confirmation Monday from a divided Senate as lawmakers braced for another epic battle over the government’s role in health care and society’s responsibility toward the vulnerable.

Indiana health care consultant Seema Verma, a protégé of Vice President Pence, was approved by a 55-43 vote, largely along party lines. She’ll head the Centers for Medicare and Medicaid Services, a $1 trillion agency that oversees health insurance programs for more than 130 million people, from elderly nursing home residents to newborns. It’s part of the Department of Health and Human Services.

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