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.

With patience and bureaucratic will, Severino’s office could roll back many Obama-era changes, and early evidence suggests this is a priority. The new administration declined to defend Section 1557, asking a federal court to stay litigation against the regulation “pending further rulemaking proceedings.” Trump highlighted religious objections to the contraceptive mandate in a recent executive order, and HHS allegedly plans to allow any organization to claim an exemption to the mandate, even if their objections aren’t faith-based, according to a leaked draft published by Vox. (OCR declined to comment on the accuracy of the document.)

For his part, Severino has been an outspoken advocate against abortion and same-sex marriage. When he was appointed, liberal advocacy groups were in an uproar: The Human Rights Campaign, for example, called him a “radical anti-LGBTQ-rights activist” who “has made it clear that his number-one priority is to vilify and degrade” people who are lesbian, gay, bisexual, and transgender. Severino spent seven years in civil-rights enforcement at the Department of Justice; before that, he litigated religious-liberty cases. He has experience. He just doesn’t share the ideological convictions of many who work in his field.

Civil-rights enforcement is a political football in America in part because so much governance is administrative. In the absence of a clear congressional mandate on controversial social issues, agencies are left to interpret their way through ambiguous statutes, and their rulings are often later challenged in court. In the realm of health care, the implications of this politicization could not be higher: People’s consciences, dignity, financial well-being, and lives are at stake.

Severino was born in the mid-1970s to poor Colombian immigrants. His father worked at a bulk-mail distribution facility, eventually becoming a supervisor, and in his late childhood, his mother was on an assembly line mounting electronic parts. Growing up in California, he was surrounded by diversity: families who spoke only Spanish, like his, but also white people who weren’t inclined to welcome newcomers. He told me stories about the first time another kid called him a wetback—a slur against Mexicans living in the country illegally—and teachers who were skeptical that a Hispanic kid could take honors classes. “For me to end up going to Harvard Law School and working at DOJ Civil Rights is one of those only-in-America stories,” he said. “That’s helped shape me and my thinking, and my approach to civil rights.”

In this way, Severino fits the typical profile of a civil-rights lawyer: He says he’s motivated by stories of discrimination. “I still kind of joke with my wife, when we go to black-tie affairs, if I’m going to get mistaken for a waiter again this time, which still happens,” he said. “People experience a whole lot worse than I did.”

Several of the cases Severino worked on at the Department of Justice focused on racial and ethnic conflicts. A major suit settled in 2013, for example, alleged that St. Bernard Parish in Louisiana had restricted its housing permits to keep black families from renting there after Hurricane Katrina. Okechukwu Okafor, a New Orleans-area landlord who won $143,609 in the settlement, said Severino “was even more upset than me” about what happened. “When you see someone like that who has a heart to want to help somebody who cannot help himself … [it] shows character,” he said.

Severino diverges from the typical D.C. civil-rights-lawyer type. He’s deeply conservative and religious: He really came into his Catholicism in law school, he told me, and describes himself as “a big believer in [religious] conscience.” He and his wife, Carrie, have spent years in conservative advocacy. She runs the Judicial Crisis Network, which pushes for conservative judicial appointments. Earlier in her career, she clerked for Justice Thomas—“one of my heroes,” her husband told me.

Before Severino came to OCR, he led a center on religion—named for and funded in part by the family of the education secretary, Betsy DeVos—at the Heritage Foundation, the conservative Washington think tank. He also worked at the Becket Fund, the religious-liberty law firm best known for its victories in Burwell v. Hobby Lobby and Little Sisters of the Poor v. Burwell—cases litigated after Severino’s tenure that challenged Obamacare’s contraceptive mandate on religious grounds.

Severino described conscience protection as a priority for his office—a term used for legal safeguards around religious liberty, often specifically referring to abortion or birth control. He cited a handful of provisions that protect health-care providers who object to abortion and sterilization, including the Weldon amendment and the Church amendments. OCR might intervene if a Catholic hospital is sued for refusing to perform abortions, for example, or if a nurse is fired for declining to assist with a vasectomy.

The issue that most sets Severino apart from others in the D.C. civil-rights community is LGBT rights. At Heritage, Severino vigorously argued against legalizing same-sex marriage and mandated accommodations for transgender individuals in school locker rooms or public bathrooms. He also took a strong stance against the previous administration’s ruling on Section 1557. In a January 2016 report co-authored with Ryan Anderson, who also led Heritage’s campaign against the legalization of same-sex marriage, Severino argued that “gender identity and sexual orientation … are changeable, self-reported, and entirely self-defined characteristics” that do not deserve the protected-class status given to sex, race, and several other categories under federal civil-rights statutes.

“Many people reasonably believe that maleness and femaleness are objective, biological realities,” they wrote. “Yet the regulations would label these kinds of reasonable beliefs as ‘discriminatory’ and seek to forbid them from being followed in the coverage or provision of health-care services.” In their view, OCR’s proposal was “another regulatory scheme under Obamacare that will inject Washington bureaucrats into intimate medical decisions without adequate justification.”

Full story at The Atlantic.