"Ms. Burwell, you have a reputation for competence," said Sen. Lamar Alexander, R-Tenn. "And if I might respectfully suggest: You're going to need it."
Members of the Senate Health, Education, Labor and Pensions Committee had nothing but good things to say about Burwell's tenure as the director of the Office of Management and Budget, a position to which she was confirmed unanimously last year, and her roles at the Bill and Melinda Gates Foundation and the Walmart Foundation.
"She doesn't come with a single experience that would make her a good secretary," said Sen. Richard Burr, R-N.C. "She comes with a whole portfolio of skills to address the challenges that agency has."
Despite their praise for the nominee, Republican members warned their approval would not mean they would soften their criticism of the Affordable Care Act.
Alexander was one of several senators who expressed continuing concerns states were being forced into one-size-fits-all regulations against their will. Burwell responded by saying she would aim to balance allowing flexibility for states' individual needs in implementing the healthcare law's regulations, and holding firm on the goals of the law.
"Where you meet in that space, having enough standardization that meets the principles but flexibility to meet the varying needs of states is something that would be important in how I would think about that issue," she said.
And despite criticism of the law, Burwell did not shy away from praising its successes.
"The implementation of the changes in the Affordable Care Act are reducing the deficit and providing great savings," she said.
Burwell noted that the Congressional Budget Office estimates the law has decreased healthcare costs by more than $900 billion between 2014 and 2020, and the administration's budget proposal could extend the solvency of Medicare Trust Fund by five years.
Sen. Tim Scott, R-S.C., wondered whether Burwell would be "the ambassador of Obamacare, or whether you will be the Secretary of Health and Human Services."
"I am part of the president's administration, and I'm honored to be appointed," she said, "but first and foremost, I serve the American people."
"I believe that the president and his policies are aligned with that, but I am here to serve the American people."
The Senate HELP committee will not hold a vote on Burwell's confirmation. The Finance Committee is expected to announce the date of their confirmation hearing shortly.
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