The quiet surrender on a subject that’s energized GOP fiscal hawks for the better part of a decade comes as new projections show Medicare’s trust fund in its worst shape since the recession, partly because of Republicans’ other chief obsession: their sweeping tax cuts.

That’s left conservatives unsure how to agitate for a politically unpopular Medicare overhaul — one that President Donald Trump detests — and raises new questions about who will take up the entitlement reform mantle as Ryan heads for the exits.

“It takes two houses of Congress and a president to want to do that,” said Sen. Roy Blunt (R-Mo.), lamenting the party’s apathy over Medicare. “No matter who’s been in the House or who’s been speaker, we have not been able to get entitlement reform done.”