The Atlantic

The Man Behind Trump's Religious-Freedom Agenda for Health Care

Roger Severino, the devout, conservative head of civil-rights enforcement at HHS, shows the power of behind-the-scenes figures in a dysfunctional Washington.
Source: Emily Jan / The Atlantic

The offices inside the Department of Health and Human Services are aggressively tan. Roger Severino, the newly appointed head of its Office for Civil Rights, hasn’t done much by way of decoration. Aside from a few plaques and leftover exhibits from old cases, his Clarence Thomas bobblehead doll and crucifix are the only personal touches in his work space.

The media spends a lot of time tracking Donald Trump’s every move and chasing down members of Congress, but much of governing happens in these bland halls. Under Trump, HHS may see more changes than any other agency, in part because the president’s predecessor left his biggest mark here. As Congress stalls on passing a new health-care bill, the Trump administration can still fight Obamacare with revised regulations, rejiggered budgets, and lackluster enforcement.

Severino leads the office that could shape the future of two of the most high-stakes aspects of the health-care debate: abortion and contraception access and LGBT rights. OCR, as it’s known, is responsible for investigating civil-rights violations in health-care settings, including discrimination on the basis of race, sex, religion, and national origin. Under Barack Obama, HHS faced religious objections to the Affordable Care Act’s requirement that most employers cover birth control in their insurance plans, and OCR has dealt with the fall-out of those fights. It developed strict requirements for the language services hospitals have to provide to non-English speakers. Most controversially, it was responsible for interpreting Section 1557, the part of the health-care law that prohibits discrimination.

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