The Biden administration’s nominee to lead the Food and Drug Administration, Robert Califf, survived a Senate procedural vote, 49-45, on Monday evening with the help of five Republicans.

A confirmation vote on the Senate floor is expected to take place Tuesday, and it’ll likely be a close one. Sens. Susan Collins, R-Maine; Lisa Murkowski, R-Alaska; Mitt Romney, R-Utah; Richard M. Burr, R-N.C.; and Roy Blunt, R-Mo., joined Democrats to help shut off debate on Califf’s nomination.

Califf faced controversy throughout his nomination process from both parties. The former FDA commissioner had to cut deals with multiple lawmakers ahead of the floor vote, trading policy promises for votes. Several Senate Democrats opposed Califf’s nomination, due to his past ties to the pharmaceutical industry and handling of the opioid crisis when he led the FDA during the tail end of the Obama administration.

Democratic Sens. Joe Manchin III of West Virginia, Maggie Hassan of New Hampshire, Edward J. Markey of Massachusetts and Richard Blumenthal of Connecticut have all publicly said they’ll oppose Califf’s nomination in a final floor vote.

Califf also faced Republican questions about medication abortion, which was expanded under his prior tenure. Several groups that oppose abortion fought Califf’s nomination this time.

Califf previously served as FDA commissioner for less than a year during the Obama administration after being confirmed with a resounding, bipartisan 89-4 vote.

Acting FDA Commissioner Janet Woodcock has led the agency since January 2021.