The big picture: Trump has scored few big legislative wins so far, and will instead head into 2020 with a policy record that comes largely from executive action, like regulations to expand bare-bones health insurance plans and roll back Obama-era energy standards.

• But many of those actions would be at risk if he loses in 2020. (This is not a prediction that Trump will be a one-term president; only an acknowledgment that that’s 1 of the 2 possible outcomes of the election.)
• A Democratic president could reverse many of Trump’s decisions just as easily as he reversed some of Barack Obama’s. Other steps that would normally be harder to reverse may not be fully cemented by January 2021.

“It’s a fairly slim record, even judging against single-term presidents, partly because the legislative achievement list is so short,” said Andrew Rudalevige, an expert on the presidency who has published books on both the Obama and George W. Bush legacies.

Trump’s economic policies are the area most likely to outlast a one-term presidency, Axios’ Dion Rabouin writes.

• Undoing the 2017 tax cuts would take another act of Congress. And those tax cuts, coupled with skyrocketing federal spending under Trump, have sent annual budget deficits over $1 trillion for the foreseeable future.

But on many of the biggest domestic policy issues, his impact has been lighter.

• On health care, the administration is falling short of its original ambitions. The Affordable Care Act is still standing. Several big regulatory ideas have fallen by the wayside; or won’t be finished by 2021; or are meeting resistance in the courts. Some will make it through, but their cumulative impact would be a lot smaller than what Trump once envisioned.
• On energy, too, big-picture promises of bringing back the coal industry have fallen flat, Axios’ Amy Harder writes, while many efforts to roll back Obama-era rules and other regulatory changes are caught up in delays and legal challenges.
• On trade, a Democratic president could unilaterally unwind Trump’s trade war, although it’s not clear that a President Sanders or a President Warren would want to.

Yes, but: More substantial elements of Trump’s time in office — his political impact, and most of all his reshaping of the federal judiciary — could help cement a greater policy footprint than Trump has so far secured for himself.

• It’s a long shot, but if the courts do end up striking down the entire Affordable Care Act, as the Justice Department has urged them to do, that certainly would count as a health care legacy.

Similarly, on immigration, experts told Axios’ Stef Kight that Trump’s successor won’t have a hard time grappling with Trump's policies — many of those specific decisions could be easily reversed — but rather, the hardened politics in an area where compromise had once seemed possible.

• “Politicians on both sides no longer feel they have permission to compromise or they don’t want to spend the political capital," said Ben Johnson, the executive director of the American Immigration Lawyers Association.

Many of Trump’s social policies also are not particularly durable on their own, but could be with an assist from the courts.

• Trump has reversed or modified Obama-era rules on abortion and LGBTQ nondiscrimination, but in some of those cases Obama had reversed Bush-era rules and a Democratic president could change them yet again.
• Trump’s ability to reshape the courts, however, will likely lead to a significant narrowing of abortion rights.

The other side: “Along with record job growth, rising wages, fair and reciprocal trade deals, energy independence, lower prescription drug prices, criminal justice reform, securing our border, and judicial appointments who uphold the Constitution, this president is helping America win again," White House spokesman Judd Deere said.

What’s next: Election Day is still more than a year away, and Inauguration Day is even further. That gives him time to keep trying — especially on drug prices and trade, where the White House is working hard to strike one more legislative deal.

• He'll also be able to keep appointing judges for the next year and a half, at least — a legacy that will tie Democrats' hands long after 2020.

Where it stands:

• The administration scrapped its own plan to overhaul drug rebates. Its proposal to tie some drug prices to the prices European countries pay may not be finished by January 2021, leaving it in the hands of whoever wins in 2020.
• A Democratic successor could stop approving Medicaid work requirements — one of Trump’s most impactful health policies — and perhaps even pressure states to ditch the requirements Trump approved. And that’s assuming the courts don’t put a definitive stop to work requirements first.

On the Affordable Care Act front, both Barack Obama and Trump changed the rules dictating how long consumers can keep short-term insurance plans; another Democrat could probably change them again. Actions like promoting ACA enrollment would be easy to resume.

• That leaves association health plans — not exactly a marquee policy.

Yes, but: Price transparency could become an exception — a real and lasting legacy, even from a one-term administration.

• New rules require drugmakers to list their prices in their TV ads, and the administration has also proposed new price-disclosure rules for hospitals.
• Those requirements would have to survive lawsuits from their respective industries, but they’re the kind of thing a Democratic administration might not want to reverse.
• On the other end of the “Yes, but” spectrum is the lawsuit aiming to get the entire ACA struck down. As long as the odds may be, if the Trump administration gets its way, that would certainly count as a health care legacy.

What we’re watching: All of this also helps explain why the White House is so eager to strike a legislative deal on drug prices. Legislation is generally more durable than executive actions, and on health care, the administration needs something that can last.

Long-term care — the kind of services typically performed in a nursing home or by a home health aide — largely falls through the cracks of both public and private health insurance, saddling seniors and their families with financial and emotional burdens they often didn’t anticipate or plan for.

• “It’s a problem nobody’s talking about,” said David Grabowski, a health policy professor at Harvard who studies long-term care. “Part of that’s just, these are hard issues to think about. Nobody wants to think about getting old and needing care. But part of it is that these are really hard problems.”

By the numbers: Estimates differ on the specifics, but they generally agree that somewhere between half and two-thirds of seniors will need at least some long-term care.

• Today’s seniors will incur an average of $138,000 in long-term care bills, according to one federal study.
• Even middle-class seniors are largely unable to cover those costs, according to a study published earlier this year, which Grabowski co-wrote.

How it works: Medicare doesn’t cover most long-term care services. The market for private long-term care insurance is tiny and fraught with failure.

• That leaves three real options: Be rich enough to pay out of pocket, be poor enough to quality for Medicaid, or lean on family and volunteer caregivers.
• In many cases, seniors must do all three: They begin paying out of pocket, then quickly spend everything they have, making them Medicaid-eligible, but still rely on family members for at least some additional help.

Medicaid is already the biggest line item in most states’ budgets — so as the need for long-term care grows, it will cost seniors, families, states and the federal government all at the same time.

The intrigue: A lot of long-term care has recently shifted away from nursing homes and toward home care or community-based options like assisted-living facilities.

• That’s a good thing for seniors, but “the challenge with it is it sort of widens this gap between the haves and the have-nots,” Grabowski said.
• Medicaid is still structurally tilted toward nursing homes, and when it does pay for home care, it doesn’t pay home care workers very well.

That leads to yet another problem — high turnover among nurses and caregivers, which isn’t great for patients.

• Home care workers are also predominantly immigrants, tying this issue up with yet another charged political debate.

The bottom line: I asked Richard Johnson, who leads the Urban Institute’s program on retirement, why there isn’t a bigger political constituency to change this system.

• “If you provided this benefit, lets say you made paid home care more affordable, there’s always a concern that it could lead to less family care,” he said.
• “Look at child care,” he said. “We don’t have much of that, either.”

Go deeper: The unofficial health care system