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Her assurance against an approach reviled by Republicans and industry leaders came during a two-hour Senate confirmation hearing at which Burwell received an important endorsement from Republican Senator Richard Burr of North Carolina. Burr sits on the Senate Finance Committee, which will decide whether to send her nomination to the floor for a final vote.

"I will vote for her in the Finance Committee," Burr said in the latest sign that Burwell's nomination is in for a smooth confirmation ride through the Senate. "I look forward to her confirmation being quick and our ability to then work together to be every bit as quick."

A widely respected technocrat known as an effective problem-solver, Burwell also won the backing of the health insurance industry's powerful lobbying and trade group, America's Health Insurance Plans, which described her in a statement as "uniquely qualified" to lead the Department of Health and Human Services.

Burwell appeared on Thursday before the Senate Health, Education, Labor and Pensions Committee for her first of two hearings. The Finance Committee has yet to set a date for its proceedings, but Democrats who control the Senate hope to have her confirmation wrapped up before the U.S. Memorial Day holiday on May 26.

Obamacare is intended to extend subsidized health coverage to millions of uninsured Americans through new online private insurance markets and an expansion of the Medicaid program for the poor. Nearly 13 million enrolled in coverage for 2014, including over 8 million through the private insurance markets known as exchanges, according to the administration.

Foes of the law have long vilified it as a ploy for moving the $3 trillion U.S. health system to a single-payer format run by the federal government instead of the private sector, a claim that has gained new life in this year's congressional election campaign.

Republican Senator Pat Roberts of Kansas asked Burwell if such a move was her "endgame," citing top Democrats, including Senate Majority Leader Harry Reid, as having endorsed the idea.

But Burwell reminded Roberts that the centerpiece of Obamacare is a private market-based insurance system of state-based health insurance exchanges.

"That's what the exchanges are," she told Roberts. "I look forward to, if confirmed, making that system work as efficiently and effectively as possible, both in terms of cost and access."

While still under questioning by Roberts, Burwell sought to ease another conservative fear: the Independent Payment Advisory Board, or IPAB, a 15-member government panel maligned by Republicans as a "death panel" because of its intended role in trimming costs within Medicare, the government healthcare program for the elderly and disabled.

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Burwell seeks to allay Republican fears about Obamacare