This article is from the archive of our partner National Journal

The Senate narrowly confirmed a new surgeon general whose nomination was delayed for months in a fight over his comments alleging that guns are a public health issue. The confirmation represents a victory for gun-control advocates, even as recent polling has shown Americans moving in the other direction toward gun-rights protections.

The Senate's 51-43 vote confirming Massachusetts physician Vivek Murthy as the next surgeon general marks the end of a protracted fight over gun control and Murthy's views on it. Murthy, who will be the first Indian-American surgeon general to serve in the U.S., waited more than a year for Senate confirmation after the National Rifle Association and other pro-gun groups threatened to throw their resources against members supporting his nomination. Senate Majority Leader Harry Reid determined earlier this year that he couldn't put his red-state members in that position before the 2014 midterm elections and shuffled Murthy to the back of the nominations pile.

Indeed, three pro-gun Democrats opposed the nomination on Monday evening: Sens. Joe Donnelly of Indiana, Heidi Heitkamp of North Dakota, and Joe Manchin of West Virginia. Manchin is up for reelection next year in an increasingly red-leaning state and is already facing Republican attacks—particularly on guns. Manchin, who won his seat in part thanks to his Second Amendment bona fides, lost the favor of the NRA in the wake of the Sandy Hook Elementary shootings, when he cosponsored legislation with Republican Sen. Pat Toomey to tighten restrictions on gun ownership.

Murthy got supporting votes from the five Democrats who lost their seats in the 2014 midterm elections: Sens. Mark Begich of Alaska, Kay Hagan of North Carolina, Mary Landrieu of Louisiana, Mark Pryor of Arkansas, and Mark Udall of Colorado all voted for Murthy, despite having faced advertising that questioned their commitment to gun rights throughout their campaigns. 

Sen. Mark Kirk, a moderate Republican from Illinois, was the only member of his party to vote for the Murthy nomination.

The vote comes just a day after the second anniversary of the Newtown, Conn., elementary school shootings and on the same day a gunman killed five people in Pennsylvania. But Murthy's confirmation also comes on the heels of a national Pew Research Center poll showing that support for gun control could carry a higher political cost than it has in the past. For the first time in more than 20 years, Americans believe it is more important to protect the rights of gun owners than to control gun ownership, according to the Pew survey.

The survey also shows that Republicans continue to believe, by a wide margin, that guns are more likely to protect citizens from crime than they are to put citizens' safety at risk. Democrats as a whole feel the opposite. But Democrats who identify themselves as moderates are nearly equally divided on the issue, and African-Americans, a key voting block for the party, now strongly believe that guns are more likely to protect than to harm by a 13-point margin—a stunning 25-point jump from 2012.

The divisions were evident throughout Murthy's long path to confirmation.

Conservatives have jumped on Murthy's comments linking gun control to public health, as well as a letter that the group he cofounded and heads, Doctors for America, sent to Congress after the Newtown shooting. "As health care professionals who are confronted with the human cost of gun violence every day, we are unwavering in our belief that strong measures to reduce gun violence must be taken immediately," Murthy wrote in the letter.

That statement, and other similar points Murthy has made about gun violence, earned him the endorsement of Americans for Responsible Solutions, the advocacy group started by former Rep. Gabrielle Giffords and her husband, Mark Kelly, after she was injured in a mass shooting in Arizona in 2011.

But it outraged conservatives, who have argued fiercely against his nomination. Every Republican member of the Senate's Health, Education, Labor, and Pensions Committee, which vetted Murthy, voted against his nomination in February, with the exception of Mark Kirk.

"I believe Dr. Murthy has disqualified himself from being Surgeon Gen because of his intent to launch an attack on our right to own firearms," Sen. Rand Paul, R-Ky., wrote on Twitter this weekend.

Murthy and his supporters in Congress have argued that obesity, not gun control, will be the focus of his tenure as surgeon general, and he vowed as much during his confirmation hearings before the HELP Committee.

Despite the controversy, thanks to Reid's invocation of the nuclear option earlier this year and the absence of six senators, Democrats needed just 48 votes to confirm Murthy. And after the elections, in which many red-state Democrats lost their reelection battles—despite, as Dave Weigel noted today, catering to the gun lobby—the party had the cover they needed to bring Murthy back up for consideration. Reid moved Murthy back up to the top of his list, making the nomination the first vote of his final week as majority leader.

Republican Sen. Ted Cruz's move to force members to work all day Saturday allowed Reid to expedite Murthy's nomination and 23 others, allowing Democrats to confirm some of President Obama's top picks before recessing for the rest of the year. "Was worried Dr. Vivek Murthy might not get confirmed but thanks to @TedCruz, looks like he will," Sen. Chuck Schumer snarked on Twitter over the weekend.

Regardless of Republican objections, Democrats argued that the Ebola crisis made Murthy's confirmation even more of a priority. "We should not let his confirmation stall over public policy debates unrelated to the position in which he would serve," Sen. Bob Casey, who sits on the HELP Committee, said in a letter to colleagues this week urging support for Murthy's nomination. "In the months since Dr. Murthy was nominated, our Nation has faced a new public health threat, in the form of the first multi-nation Ebola epidemic. At a time when the American public is worried and unsure of what might happen, the role of 'America's Doctor' remains unfilled."

Other members have questioned Murthy's credentials to be the nation's leading public health official. Murthy is a graduate of both Harvard and Yale universities, but at 37 years old has only worked as a physician for a decade and has not worked in public health. "Unfortunately, Dr. Murthy's experience does not demonstrate the leadership and knowledge of public health that we expect from our surgeons general," Republican Sen. Lamar Alexander, who serves as the ranking member on the HELP Committee, said in a statement this weekend.

Republicans are concerned that Murthy will use the position largely to advocate for the Obama administration, politicizing the position of surgeon general. Murthy's group, Doctors for America, advocated strongly for the passage of the Affordable Care Act, and the group itself is an offshoot of the Doctors for Obama organization that campaigned for the president. "The people don't want a Democratic or Republican Surgeon General, just as they don't search for their personal physician by political affiliation. They want the best, most qualified physician to entrust with their health," former Surgeon General Richard Carmona wrote in an op-ed opposing Murthy's nomination earlier this month. (Carmona served under President George W. Bush, but later ran for the Senate in Arizona as a Democrat.)

And the criticism continued Monday. "With America facing the challenge of Ebola and other serious health challenges, it's unfortunate that the President chose a nominee based on the candidate's political support instead of a long career delivering patient care and managing difficult health crises," Senate Minority Leader Mitch McConnell said in a statement.

This article is from the archive of our partner National Journal.

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