confirmed by the Senate on January 24, 2018, and sworn in by Vice President Pence on January 29, 2018. From March to December 2018, Azar sat on the Federal Commission on School Safety. Azar had prolonged disputes with Seema Verma, who was Trump's administrator of the Centers for Medicare & Medicaid Services (CMS). She accused Azar and his HHS predecessor, Tom Price, of sexist management; an inquiry by a former Trump HHS official, Heather Flick, concluded that Azar had not discriminated. On January 20, 2021, immediately after the end of the Trump administration, China sanctioned Azar and other Trump administration officials. The sanctioned people cannot travel to China and cannot do business with China. President Biden's National Security Council called the sanctions "unproductive and cynical." Healthcare policy Security Strategy As Secretary of Health, Azar presided over the release of the Trump administration's National Biodefense Strategy in 2018 and the Global Health Security Strategy in 2019. Affordable Care Act Azar has been a critic of the Patient Protection and Affordable Care Act (Obamacare) and predicted in 2017, "There will be a piece of legislation passes this year that is called the repeal of Obamacare. I don't know what's going to be in the substance of it, but there will be a piece of legislation that says that." Also regarding the ACA, Azar said the Department of Health and Human Services has latitude to "make it work a little better". Abortion Azar opposes abortion. In a written response to Senator Patty Murray regarding future HHS policy, he said, "The mission of HHS is to enhance the health and well-being of all Americans, and this includes the unborn." Regulations According to The New York Times, Azar differed with his predecessor, Tom Price, in his approach to regulations. Writing in May 2018, the Times said, "in a sharp break from his predecessor – and from most Trump cabinet secretaries – he seems to be relishing the chance to write new regulations, rather than just crossing out Obama-era ones." COVID-19 Outbreak Azar learned about the coronavirus threat on January 3, 2020. Azar informed associates that he had alerted Trump on January 18, 2020, regarding the potential danger from COVID-19, but that the president thought he was being "alarmist" as Azar struggled to get Trump's attention to focus on the issue. Despite Azar's warnings, four days later, Trump announced, "We have it totally under control. It's