U.S. Sen. Joe Manchin (D-WV), who said Friday that he would support Brett Kavanaugh’s confirmation to the U.S. Supreme Court, very likely didn’t have to join the GOP to push through Kavanaugh, according to West Virginia polling data.

Manchin, whose conservative policy stances have long vexed congressional Democrats and progressive activists, voted on Friday to end debate on Kavanaugh’s nomination, even as Sen. Lisa Murkowski (R-AK) voted against the procedural measure. Support from Manchin and Sen. Susan Collins (R-ME) ensures that Kavanaugh, who is accused of sexual misconduct by several women, will replace Justice Anthony Kennedy on the Court.

But polling shows Manchin was hardly in a precarious political position: The former West Virginia governor and scion of a political family leads his Republican opponent by as many as 12 points, with FiveThirtyEight giving Manchin an 87.9 percent chance of winning reelection in November.

Another Senate Democrat up for re-election in a state that voted for Donald Trump in 2016, Sen. Heidi Heitkamp (D-ND), looks like a profile in courage compared to her colleague from West Virginia. Heitkamp, to whom FiveThirtyEight gives a 31.5 percent chance of winning her Senate race in November, came out strong against Kavanaugh’s confirmation, no matter the political consequences.

Supporting Kavanaugh’s nomination might be justified if Manchin were facing a tight race to retain his Senate seat and the Supreme Court were at the top of his constituents’ main concerns headed into the midterms. But health care, not the Supreme Court, is by far the most important issue for West Virginia voters, according to polling data released in late September. Kavanaugh’s confirmation to the Court is tied for the third most important issue for voters in West Virginia.

Kavanaugh, meanwhile, is primed to join the Court’s conservative justices in ruling against the Affordable Care Act (ACA) and any future law aiming to expand health-care access. It was a month ago that Georges Benjamin, executive director of the American Public Health Association, expressed alarm about Kavanaugh’s past health-care rulings, telling Healio, “we have enormous concerns and … we would like someone else to be chosen for the court.”

West Virginia was among the 17 states that saw uninsured rates jump in 2017, as congressional Republicans and the Trump administration waged bureaucratic war against the ACA, also known as Obamacare.

“I have concerns that if confirmed, Kavanaugh could issue rulings that could result in significant loss of coverage for many Americans,” Simon F. Haeder, a political science professor at West Virginia University, told Healio. 

West Virginia voters’ approval of Trump remains among the highest in the United States, though it has dropped by ten points since the start of 2017. A so-called red state Democrat opposing the president’s judicial nominee isn’t as politically dangerous today as it would have been a year ago. The data says Manchin would likely win reelection without joining the GOP in putting Kavanaugh—whose confirmation is opposed by more than 2,400 law professors—on the nation’s high court. So why would he?