The Senate confirmed Seema Verma to lead the Centers for Medicare and Medicaid Services, an agency that will have a major role in implementing any health reform that repeals and replaces Obamacare.

The Senate voted 55-43 to confirm Verma Monday evening. Verma is a health policy consultant who crafted Indiana’s Medicaid expansion program when former Gov. Mitch Daniels and then Vice President Mike Pence ran the state.