Trump will want a major victory early. A successful Supreme Court nominee, from a list he has already provided, might give him breathing room with conservatives who mistrust him, as will the inevitable fevered, ultimately futile opposition from Democrats. Their opposition to his political appointees will be as implacable as Republican opposition was to President Obama’s, and Democrats will be under intense pressure from their base to try and disrupt any traction that Trump might generate from early and easy confirmations.
The new president will need more to generate real momentum: a big domestic policy accomplishment. In the abstract, he can count on the support of his entire party. On a concrete level, he might find that Republicans cut from a different part of the cloth will offer him surprising resistance. His mandate might not be theirs. He might decide on something that commands majority support from a cross-section of Americans. He is fickle that way.
Repealing and replacing ObamaCare will take a while. Some provisions of the bill haven’t kicked in yet, and the Affordable Care Act’s reach extends to dozens of government agencies, and into state governments. It has metastasized; it cannot be extricated from the body politic like a benign tumor. A number of Republicans want ObamaCare to slowly starve itself to death, exhausting the available supply of governments funds over the course of several years. Its protections remain widely popular and the prospect of many of Trump’s own voters going without health insurance will slow down the pace of reform, perhaps considerably. By the end of next year, the American health care system will look a lot different than it does now. How Trump gets rid of ObamaCare while keeping his promise to cover everyone is a mystery at the moment.
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