Businessman Luis Quinonez on Saturday formally withdrew his name from consideration to be president-elect Donald Trump's new Veterans Affairs secretary, citing health concerns.

The move leaves Cleveland Clinic CEO Toby Cosgrove as the most likely candidate to take over the Cabinet-level post, but also adds even more uncertainty to the appointment. Trump has already announced his picks for almost all of the other prominent administration positions, but transition officials have said he is taking time to find the perfect candidate for the embattled VA.

Quinonez, a Guatemalan immigrant who served in the Marine Corps and Naval Reserves, is a well-known figure among Republican power brokers but is not as connected to veterans organizations as are other candidates.

Today, his firm -- MAQ Diversified -- has 2,200 direct medical staff in addition to a network of 25,000 physicians and 8,000 pharmacists. His responsibilities include operating hospitals and clinics in multiple states, and overseeing a health care plan for military dependents and retirees in numerous southern states.   

Quinonez worked closely with Trump's presidential campaign, serving as a member of the president-elect's Hispanic Advisory Council. He has previously served as president of the US-Central America Chamber of Commerce, is a co-founder of the Hispanic College Fund and was an official observer to El Salvador's peace negotiations.

He was seen as a top candidate for the post, given his health care background and reports that Trump wants to include a Hispanic voice in his administration's top circles. But Quinonez has battled cancer in recent years, a factor individuals close to him said pushed him to reconsider the demands of the high-profile post.

Quinonez has also been involved in a years-long legal dispute with Virginia officials over child support issues stemming from a bankruptcy filing more than a decade ago. State court officials have pursued him for thousands of dollars in fees and penalties for payment problems, but they’ve also acknowledged past clerical mistakes that have confused the situation.

It’s unclear how that legal situation may have affected a confirmation process.

Trump has already outlined ambitious promises to overhaul the $180-billion, 365,000-employee Veterans Affairs department, which has struggled to regain public trust since the 2014 wait times scandal that forced the resignation of then-VA Secretary Eric Shinseki.

In recent days, Trump officials have said the president-elect is considering massively expanding private-care medical options for all veterans, a move which critics have decried as effectively privatizing VA operations.

On the campaign trail, Trump promised a crackdown on accountability in the department; an expansion of outside care options for veterans; and the creation of a commission to "investigate all the fraud, cover-ups, and wrongdoing that has taken place in the VA" in recent years.

Veterans groups have praised progress made under current VA Secretary Bob McDonald, but transition officials suggested that the president-elect has not seriously considered retaining the Obama appointee in the new administration.

Transition officials still hope to have a VA secretary in place within days of Trump’s inauguration next month.

Cosgrove, 75, is a former Air Force surgeon and nearly became VA Secretary in 2014, when he turned down President Obama’s offer to help reform the massive veterans bureaucracy. He has also rebuffed efforts by the president to serve in the department’s top health role in recent years.

But he has been a close confidant of Trump, meeting with him and other health care industry leaders earlier this month to discuss policy options for the next administration.

Other candidates under consideration include Pete Hegseth, a Fox News commentator and former president of Concerned Veterans for America, and former Massachusetts Sen. Scott Brown.

Leo Shane III covers Congress, Veterans Affairs and the White House for Military Times. He can be reached at lshane@militarytimes.com.