Foreign Affairs. The bill has 225 co-sponsors. The bill called for former President George W. Bush to recognize and use the word genocide in his annual 24 April speech which he never used. His successor President Barack Obama expressed his desire to recognize the Armenian genocide during the electoral campaigns, but after being elected, did not use the word "genocide" to describe the events that occurred in 1915. The US House of Representatives formally recognized the Armenian genocide with House Resolution 296 on 29 October 2019. The United States Senate unanimously recognized the genocide with Senate Resolution 150 on 12 December 2019. In 2021, President Joe Biden became the first U.S. president to formally recognize the Armenian genocide. As of 2022, all 50 U.S. states have also recognized the events as genocide. Disputes Nagorno-Karabakh conflict Armenia provides political, material and military support to the Republic of Artsakh in the longstanding Nagorno-Karabakh conflict. The current conflict over Nagorno-Karabakh began in 1988 when Armenian demonstrations against Azerbaijani rule broke out in Nagorno–Karabakh and later in Armenia. The Nagorno-Karabakh Autonomous Oblast voted to secede from Azerbaijan and join Armenia. Soon, violence broke out against Armenians in Azerbaijan and Azeris in Armenia. In 1990, after violent episodes in Nagorno–Karabakh and Azerbaijani cities like Baku, Sumgait and Kirovabad, Moscow declared a state of emergency in Karabakh, sending troops to the region, and forcibly occupied Baku, killing over a hundred civilians. In April 1991, Azerbaijani militia and Soviet forces targeted Armenian populations in Karabakh, known as Operation Ring. Moscow also deployed troops to Yerevan. Following the collapse of the Soviet Union, conflict escalated into a full-scale war between the Nagorno-Karabakh Republic (supported by Armenia), and Azerbaijan. Military action was influenced by the Russian military, which manipulated the rivalry between the two neighbouring sides in order to keep both under control. More than 30,000 people were killed in the fighting during the period of 1988 to 1994. In May 1992, Armenian forces seized Shusha and Lachin (thereby linking Nagorno-Karabakh to Armenia). By October 1993, Armenian forces succeeded in taking almost all of former NKAO, Lachin and large areas in southwestern Azerbaijan. In 1993, the UN Security Council adopted four resolutions calling for the cessation of hostilities, unimpeded access for international humanitarian relief efforts, and the eventual deployment of a peacekeeping force in the region. Fighting continued, however, until May 1994 at which time Russia brokered a cease-fire