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Photo: Saul Loeb/AFP via Getty Images

If this is the end for the Trump administration, it will leave a legacy of failure on health care, and if he's re-elected, he'll have a lot of ground left to make up.

Why it matters: The administration failed to get almost anything it wanted — sometimes the setback was Congress, sometimes the courts, sometimes the administration itself.

  • The failed effort to repeal the Affordable Care Act in 2017 is at the top of that list.
  • The administration simply didn't enact any of its most aggressive proposals on drug pricing, including plans to change the way rebates are paid within the system, to reclassify some drugs within Medicare, and to tie Medicare's prices to other countries.
  • The biggest thing it did accomplish on drug prices — a regulation requiring list prices in TV ads — was blocked in court.
  • Medicaid work requirements, probably the most significant change the administration has pursued on its own, have also been blocked in court.

What's left: Rules requiring hospitals to disclose their prices could stick around, and President Trump did change the rules for short-term insurance plans that compete with ACA coverage, although a Biden administration could change those rules again.

  • And that leaves a legacy largely defined by the failure to contain the coronavirus.

Yes, but: There's still a big wild card outstanding, in the form of the Supreme Court case over the ACA.

Go deeper

Amy Harder, author of Generate
Nov 19, 2020 - Energy & Environment

How running helps to explain climate change

Illustration: Sarah Grillo/Axios

Running a race can help illustrate how efforts on climate change should change over time.

The big picture: Climate change, unlike most other public-policy challenges, is cumulative. The longer we wait, the bigger the problem it becomes and the larger the measures needed to address it.

Dan Primack, author of Pro Rata
2 hours ago - Economy & Business

New deals in the COVID economy

Illustration: Sarah Grillo/Axios

COVID-19 is the macro horror of our lifetimes, and has destroyed or severely damaged countless businesses. But, like with most horribles, it also has created some opportunities.

Driving the news: Merck this morning announced an agreement to buy OncoImmune, a Maryland-based biotech that showed promising late-stage clinical results for a therapy that treats severe and critical coronavirus cases.

2 hours ago - Technology

Biden's openings for tech progress

Photo illustration: Eniola Odetunde/Axios. Photo: Win McNamee/Getty Images 

Item No. 1 on President-elect Joe Biden's day-one tech agenda, controlling the flood of misinformation online, offers no fast fixes — but other tech issues facing the new administration hold out opportunities for quick action and concrete progress.

What to watch: Closing the digital divide will be a high priority, as the pandemic has exposed how many Americans still lack reliable in-home internet connections and the devices needed to work and learn remotely.