Two high-profile Republicans, Sen. Lisa Murkowski of Alaska and Sen. Susan Collins of Maine, notably voted against his confirmation. Republican Sen. Mitch McConnell, the longest-serving Senate party leader, who announced Thursday he will not be seeking re-election in 2026, voted in favor of Patel's nomination, which came as a surprise to many.

Patel joins the list of nominees who endured an uphill battle before finally getting confirmed. They include Robert F. Kennedy Jr. as secretary of Health and Human Services, Tulsi Gabbard, the director of national intelligence, and Defense Secretary Pete Hegseth.