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Photo: Alex Wong/Getty Images

President Trump came into office in 2017 with big ambitions on health care. But he’ll end this term with a lot less to show.

The big picture: If Trump ends up being a one-term president — and that’s not a prediction, just 1 of the 2 possibilities in 2020 — his health care legacy would be pretty modest.

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.

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.

Go deeper

In photos: D.C. and U.S. states on alert for pre-inauguration violence

National Guard troops stand behind security fencing with the dome of the U.S. Capitol Building behind them, on Jan. 16. Photo: Kent Nishimura / Los Angeles Times via Getty Images

Security has been stepped up in Washington, D.C., and state capitols across the U.S. as authorities brace for potential violence this weekend.

Driving the news: Following the Jan. 6 insurrection at the U.S. Capitol by some supporters of President Trump, the FBI has said there could be armed protests in D.C. and in all 50 state capitols in the run-up to President-elect Joe Biden's inauguration Wednesday.

15 hours ago - Politics & Policy

The new Washington

Illustration: Sarah Grillo/Axios

The Axios subject-matter experts brief you on the incoming administration's plans and team.

Rep. Lou Correa tests positive for COVID-19

Lou Correa. Photo: Tom Williams/CQ-Roll Call, Inc via Getty Images

Rep. Lou Correa (D-Calif.) announced on Saturday that he has tested positive for the coronavirus.

Why it matters: Correa is the latest Democratic lawmaker to share his positive test results after last week's deadly Capitol riot. Correa did not shelter in the designated safe zone with his congressional colleagues during the siege, per a spokesperson, instead staying outside to help Capitol Police.