The Senate Veterans Affairs Committee agreed on voice vote to back Robert Wilkie, currently serving as a Pentagon undersecretary. Independent Sen. Bernie Sanders of Vermont cast a "no" vote.
Wilkie has pledged to "shake up complacency" at the VA, which has struggled with long waits in providing medical treatment to millions of veterans.
Under repeated questioning by Democrats during his confirmation hearing last month, the Air Force and Navy veteran insisted he would not seek to privatize the government's second-largest agency. Trump promised during the 2016 campaign to steer more patients to the private sector, calling the VA "the most corrupt."
The White House applauded the committee vote and urged the full Senate to act quickly in confirming Wilkie. It said Trump was "confident that Mr. Wilkie will continue the administration's important work on behalf of the veterans community."
Sanders has previously cited concern that Wilkie might not be committed to bolstering care at core VA medical centers. Major veterans' groups see the centers as best-suited to veterans' specialized needs, such as treatment for post-traumatic stress and traumatic brain injury.
Wilkie's nomination now goes to the full Senate. A vote could come as early as next week.
If confirmed, Wilkie will be charged with carrying out a newly signed law by Trump to ease access to private health care providers. That law gives the VA secretary wide authority to decide when veterans can bypass the VA, based on whether they receive "quality" care.
Republican Sen. Johnny Isakson of Georgia, the chairman of the committee, praised Wilkie and said he will "bring stability and leadership" to the VA. "He will prove indispensable in helping transform the VA," Isakson said.
Trump selected Wilkie for the post in May after firing former VA Secretary David Shulkin amid ethics charges and internal rebellion at the department over the role of private care for veterans.
Trump's first replacement choice, White House doctor Ronny Jackson, withdrew after allegations of workplace misconduct surfaced. Trump has since sought to pin blame for Jackson's failed bid on Montana Sen. Jon Tester, the top Democrat on the panel, who revealed the allegations made against Jackson.
Wilkie, 55, served as acting VA secretary after Shulkin's firing in March, before returning to his role as Pentagon undersecretary, a post to which he was confirmed unanimously by the Senate last November.
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