Sen. Joe Manchin, D-W.Va., will support President Trump’s choice to lead the Department of Health and Human Services, ensuring a likely confirmation.

Manchin’s office confirmed Wednesday that the senator would support the nomination of Alex Azar, an HHS veteran under the George W. Bush administration and a former pharmaceutical executive.

The support from a Democrat helps Azar as the GOP has a narrower margin in the Senate this year after the swearing in of Sen. Doug Jones, D-Ala., who replaced Republican Luther Strange. The GOP now holds a 51-49 margin in the Senate, and Vice President Mike Pence can break a 50-50 tie.

A Cabinet nomination only needs a simple majority of 51 votes to advance.

Azar has earned plaudits from Republicans for his tenure at HHS and was praised by Republicans at his second confirmation hearing Tuesday before the Senate Finance Committee.

“I believe his record shows that he is more than capable of leading HHS through these next few consequential years,” said Sen. Orrin Hatch, R-Utah, the committee chairman.

But Azar’s nomination has earned widespread disdain from Democrats who are skeptical he will rein in high drug prices.

Several Democrats on the finance committee charged that prices of several drugs rose during Azar’s five-year tenure helming the U.S. division of drug maker Eli Lilly.

Azar said drug prices are too high and the system doesn’t incentivize companies to lower prices. He said lowering prices would be a major priority under his stewardship at HHS if he gets confirmed.

The Senate Finance Committee will vote on Azar’s nomination and if successful it will head to the Senate floor.

Manchin, who is up for re-election this year, hails from a state where 68 percent of voters supported Trump.