A federal judge slapped down the administration’s approval of Medicaid work requirements — arguably the biggest change it has actually made to health policy so far.

Some congressional Republicans, meanwhile, are quietly (and not-so-quietly) hoping the administration will also lose the separate lawsuit in which it’s trying to get the Affordable Care Act thrown out.

The big picture: These are different kinds of setbacks, and there’s still a long way to go in all of these legal proceedings. But together, the crosswinds — the political resistance on one side and substantive losses on the other — leave Trump’s agenda in a precarious place.