After Department of Health and Human Services (HHS) secretary Tom Price resigned in late September following reports that he used federal money to charter private planes, President Donald Trump nominated Alex Azar to run the the agency.

Today (January 24), Azar was approved by a 55-43 vote in the Senate. Azar’s political views and his pharmaceutical industry past have given many advocates pause. We covered three of the major concerns about his nomination back in November, including his background as a pharmaceutical executive, his opposition to the Affordable Care Act and his anti-choice views.

From Dr. Anne Davis, consulting medical director for Physicians for Reproductive Health, via an emailed statement:

Mr. Azar would steer the federal agency responsible for implementing health care policy, an organization that recently underwent a deeply disturbing ideological shift with no basis in medicine. Recently, HHS issued a strategic plan that put ideology before medicine by trying to define life as beginning at conception, which could broadly impact access to reproductive health care services, like infertility services, birth control and abortion care. Officials at the Office of Refugee Resettlement, part of HHS, held a 17-year-old undocumented woman hostage to block her from finding the abortion care she needed. We fear that HHS is badly off-course and doubt Mr. Azar will make the changes needed to really put patients’ interests first.

Senator Patty Murray (D-Wash.), was among those who opposed Azar’s nomination in the Senate. As reported by The Washington Post, in her prepared speech for today’s Senate floor vote, Senator Murray said:

As a nominee Mr. Azar may try to assure us that he will fight for patients and protect the health of our communities, but after looking at his record, after reading his past statements, after discussing these issues with him, I am alarmed that he might not stand up for women and families. I am alarmed that he might not stand up to the pharmaceutical industry. And I am alarmed that he might not stand up to President Trump’s agenda driven by sabotage and ideology.

HHS has been under scrutiny recently for its move to increase religious freedom protections for providers via the agency’s new Conscience and Religious Freedom division, and its reluctance to promote open enrollment for the Affordable Care Act. Despite those efforts, the program saw 8.8 million sign-ups this year96 percent of last year’s enrollment, despite no budget for advertising and a shortened enrollment period.

The agency also runs other programs that directly impact people of color. In his new role, Azar will oversee the Office of Minority Health, which “is dedicated to improving the health of racial and ethnic minority populations through the development of health policies and programs that will help eliminate health disparities,” according to its website