WASHINGTON — Senators overwhelmingly approved Robert Wilkie as the next Veterans Affairs secretary on Monday, but the move came with political dissent for the first time in the department’s 30-year history.

The final vote of 86-9 wasn’t enough to seriously jeopardize Wilkie’s chances of taking over as the 10th VA secretary. But it did mark the first time since the agency became a Cabinet-level department that any senator has voted against a nominee for the top VA job — a post that usually rises above partisan congressional fights.

All of the opposition came from Democrats and Sen. Bernie Sanders, I-Vt. Earlier this month, Sanders said he would not support Wilkie’s nomination because of his distrust of President Donald Trump’s policies towards veterans medical care.

“Trump has been very clear about his desire to move to the privatization of the VA,” Sander said, “and I suspect any of his appointees will try and move the agency in that direction.”

The threat of outsourcing VA medical responsibilities — and funding — has dominated much of the discussion over department policy since Trump took office. One of Wilkie’s biggest responsibilities in the next year will be crafting new community care rules allowing veterans more access to private-sector doctors, a process that is expected to spur even more heated debate.

Wilkie’s past work for former Sens. Jesse Helms and Trent Lott also drew questions at his confirmation hearing, particularly his involvement with controversial issues surrounding the Confederate flag, equality issues, and Trump’s military transgender policies. Wilkie defended much of the work as routine business, but that answer failed to reassure a number of Democratic opponents.

Senate Veterans’ Affairs Committee ranking member Jon Tester, D-Mont., has also expressed concerns about Trump’s intentions with VA, but took to the Senate floor before the vote to back Wilkie as a responsible nominee to guide the department into the future.

“Right now the VA does not have a confirmed secretary who is focused on the larger mission of serving veterans, implementing the reforms, and improving VA care and benefits,” he said. “Instead, we've had temporary political appointees in charge. 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.”

Republicans in the Senate were even freer with their praise. Committee chairman Sen. Johnny Isakson, R-Ga., called the nominee “the real deal” and an exemplary pick by the president.

“Robert Wilkie understands the needs of our veteran rural areas,” he said before the vote. “He understands the needs in large urban cities. He understands the threat of suicide and our need to get mental health accessible and available to our veterans at all times. He also knows that we've given him a quiver of arrows that he can use to root out the bad players and lift the good players.”

Wilkie’s confirmation ends four months of leadership turmoil at VA, a department that boasts a budget of nearly $200 billion and more than 350,000 employees.

In March, President Donald Trump fired then-Secretary David Shulkin amid infighting at the department, and allegations by Shulkin that political operatives were working to undermine VA health care programs.

Trump’s first pick to replace Shulkin, former White House physician Rear Adm. Ronny Jackson, withdrew his name from consideration in April after allegations emerged about unprofessional behavior and medication mismanagement in his role as the administration’s top doctor.

Wilkie, 55, has been serving since last fall as the Defense Department’s under secretary for personnel and readiness. He also served as acting VA secretary for two months following the firing of Shulkin from the lead department job in March.

He has received generally positive reviews from veterans groups in recent months as a stabilizing force for a department that has seen significant turmoil since the start of 2018.

In a statement, American Legion National Commander Denise Rohan praised the move and said her staff is focused on working with the new secretary “to ensure America’s veterans receive the healthcare, education, and other benefits they have earned.”

Wilkie, 55, is an Air Force Reserve colonel who previously spent time in the Navy Reserve. He is the son of an Army artillery commander wounded in the Vietnam War, and has spoken frequently about growing up in a military family dealing with those serious injuries.

He served in the Pentagon under Defense Secretaries Robert Gates and Donald Rumsfeld as an assistant secretary, and previously was special assistant to President George W. Bush for national security affairs. Wilkie is also well known on Capitol Hill, most recently serving as a senior adviser to Sen. Thom Tillis, R-N.C., prior to his recent Pentagon appointment.

The new secretary also outlined his top department priorities in that Senate event, promising to offer “world-class customer service” at VA, expanding veterans access to medical care outside the VA system, reducing disability claims backlogs and reforming human resources systems.

Wilkie is expected to be officially sworn into his new role later this week.