President Trump notched a major legislative win at the end of 2017, delivering the tax reform package he’d promised as a “Christmas gift” to the country. The White House now faces 2018 hoping to channel that momentum into a bold list of domestic priorities for the New Year, including revisiting two failures from his first year in office.
White House spokeswoman Sarah Sanders said Trump’s major domestic priorities for reform in 2018 are health care, infrastructure, welfare and immigration.
“The president was elected because of his ambitious agenda and his desire to get a lot of things done,” Sanders said in a press briefing on Tuesday, calling those four items “top priorities for the Administration this year.”
But the White House faces strong headwinds to achieving any of these goals. While Republicans still maintain a slim majority in Congress, they’ll need cooperation from Democrats to pass any major pieces of legislation — a fraught proposition, at best. And Republicans have some time pressure to deliver wins before the midterm elections this year.
Here’s a look at Trump’s major goals for 2018.
Health care
On repealing and replacing the Affordable Care Act, Trump has already claimed a win. “When the individual mandate is being repealed, that means Obamacare is being repealed,” he said in a Cabinet meeting in December after Congress approved the tax bill. “We have essentially repealed Obamacare, and we will come up with something that will be much better.”
The tax plan repeals the individual mandate — a key part of Obamacare that penalizes people without health insurance — beginning in 2019. It’s not true to say that the tax bill repeals the health care law, which congressional Republicans have repeatedly tried and failed to do. Experts say Republicans’ previous inability to repeal the full law probably presages a failure again this year.
“I don’t see anything that’s changed in terms of the lack of support in the Senate,” says Gerald Kominski, director of the UCLA Center for Health Policy Research. “I think that it is fruitless to continue to bang your head against the wall if you are not going to get the outcome that you want.”
But Trump is correct that in certain ways he’s already hobbled the ACA, even if he fell short of an outright repeal.
“Their policies to date are destabilizing and damaging the ACA marketplace,” says Kominski. Scrapping the individual mandate, he says, already represents “significant damage” to the law.
Infrastructure
Infrastructure is another one of Trump’s campaign promises. Trump has long dangled a promise of $1 trillion in infrastructure spending, and his Administration is expected to unveil its plan in January. But while the tax bill moved forward on Trump’s ambition to kneecap that Affordable Care Act, it could provide a setback here. The tax bill increases the deficit by more than $1 trillion, which makes a massive spending package trickier to wrangle financially and a harder sell for Republicans politically.
“In the current environment that’s going to lead to a lot of skepticism, simply because they’ve been talking about tax cuts and entitlement reform. And then to say we’re going to turn around and have major spending on infrastructure reform, I don’t know how they situate that,” says Alan Auerbach, director of the Robert D. Burch Center for Tax Policy and Public Finance at Berkeley. “There’s not any magic, it has to be real money, and they [made] that real money a lot less available.”
The Administration had hoped that an infrastructure package could be a bipartisan win. “I really believe infrastructure can be bipartisan,” Trump said in December. “People want it, Republicans and Democrats.”
But again, tax reform may have made this more difficult to come by, with the party-lines vote pushing an already-strained sense of bipartisanship in Congress to the breaking point.
Welfare
Trump is expected to roll out an executive order mandating a review of federal safety net programs as soon as January. The Administration could include programs like food stamps, Medicaid and housing benefits in its targets for reform.
“Looking at any of these programs one at a time doesn’t tell you anything about the welfare system, in fact, it severely misleads you,” says Robert Rector, senior research fellow at the conservative Heritage Foundation. “I expect [the Trump Administration] to present the welfare [plan] and discuss the welfare system holistically.”
In this holistic view of welfare reform, Rector expects, the Administration could promote principles such as work requirements, removing marriage penalties from benefits, paying programs for outcomes rather than services provided and moving the cost burden of welfare programs more to the states.
But there are ideological and political divisions even among congressional Republicans on changing the welfare system, and to significantly restructure it, the party would need to unite its most moderate and conservative members. That’s a tall order, especially when an inability to do just that helped sink hopes of health care reform in 2017. And the polling on Medicaid and Social Security demonstrates why changing such programs is notoriously difficult: in April 2017, just 12% of U.S. adults said they wanted cuts to Medicaid spending, according to a survey by the Kaiser Family Foundation. In a 2017 Pew survey, 86% of Republicans and 95% of Democrats said they would like to maintain or increase spending for Social Security.
Immigration
Immigration is one of Trump’s signature issues, and it remains at the forefront of his domestic agenda in his second year. Within the first days of 2018, Trump will meet with Congressional leaders to discuss an immigration deal. He predicted on Twitter that “DACA activists and Hispanics will go hard against Dems, will start “falling in love” with Republicans and their President!”
In any deal, Trump has said he wants his campaign-promise border wall, as well as an end to chain migration and the U.S. visa lottery system. Democrats have said they will push Trump hard to protect the Dreamers, and insist that any funding for a border wall is unacceptable.
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Write to Tessa Berenson Rogers at tessa.Rogers@time.com