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Trumps White House is staffed with political neophytes, and the President himself is so inexperienced that he only yesterday determined that health care is a complicated issue.CreditPHOTOGRAPH BY EVAN VUCCI / AP

I have to tell you, its an unbelievably complex subject, President Donald Trump told a group of governors at the White House yesterday. Nobody knew that health care could be so complicated.

Trump is not an overly complicated rhetorician. He uses a few key phrasescall them Trumpismsto convey ideas that he wants listeners to believe are universal. When he uses the often mocked expressions many people are saying or a lot of people think, for example, what he really means is that he is about to say something that he personally believes, which maynot have any factual foundation, such as his comments about widespread voter fraud in the 2016 election or the size of crowds at his events.

Nobody knew is Trumpspeak for I just found out. Large-scale reform of the American health-care system is one of the most complicated policy issues the government faces, as all of Trumps modern predecessors learned.

The health care reform story illuminates almost every aspect of the presidency, David Blumenthal and James Morone writein The Heart of Power: Health and Politics in the Oval Office, a 2009 examination of how eleven Presidents, from to Franklin Roosevelt to George W. Bush, grappled with theissue. Because health reform is excruciatingly difficult to win, it tests presidents ideas, heart, luck, allies, and their skill at running the most complicated government machinery in the world.

Those who were successful at pushing reform operated in extremely advantageous environments. Lyndon Johnson and Barack Obama, two Presidents who dramatically expanded coverage, were able to pass legislation largely because they had big majorities in Congress.

President Obama had an especially favorable terrain. His White House was filled with veterans from Capitol Hill. He was operating in the emergency environment of the Great Recession, which gave him more political capital. His own party was unusually united on the framework of reform, which had its roots in conservative think tanks and had already been tried in Massachusetts by a Republican governor. Even the Democratic left, which favored a single-payer system, quickly signed on to the Obama plan. Early on in the process, Obama cut deals with the major corporate interestsdrug companies and the insurance industrythat previously had blocked reform. Most important, he had sixty Democratic votes in the Senate to block a filibuster. When his Senate majority slipped from sixty to fifty-nine, his legislation almost died.

The environment for reform under Trump is far more precarious. Trumps White House is staffed with political neophytes, and the President himself is so inexperienced that he only yesterday determined that health care is a complicated issue. Unlike the Democrats in 2009, Republicans are divided. In the House, the most conservative members are rebelling against a core component of the leading plan being developed by Speaker Paul Ryan, who favors refundable tax credits to help Americans pay for insurance. Yesterday, the leaders of the two largest groups of conservatives, the Freedom Caucus and the Republican Study Committee, separately said that they will vote against reform bills that include tax credits, which they argue are tantamount to a new entitlement program.

In the Senate, there is no consensus among Republicans on a plan to replace Obamas Affordable Care Act. For major parts of his effort, Trump can use the budget process known as reconciliation, which is not subject to a filibuster and which Obama used for a final vote on his plan after Senator Ted Kennedy died and was replaced by Republican Scott Brown. But Trump will still need sixty votes to complete an overhaul of the current system. There are currently only fifty-two Republican senators.

The White House staff is reportedly divided over the way forward, with Trump aide Jared Kushner and Gary Cohn, the head of National Economic Council, seen as skeptics of the House proposal, according to theTimes. Reince Priebus, Trumps chief of staff, and Tom Price, a former Republican congressman who is now Secretary of Health and Human Services, favorthe Ryan approach.

Other important constituencies are also divided. The governors who met with Trump yesterday expressed an array of opinions about what he should do regardingthe Medicaid expansion initiated by Obama. Under Obama, the insurance industry, which has frequently torpedoed reform, accepted new regulations, including a ban on denying coverage to new policyholders with prexisting medical conditions, in exchange for the individual mandate, which required Americans to buy their products. Republicans want to keep the ban and get rid of the mandate, a deal that might be worse than the status quo for most insurers, without additional concessions.

The A.C.A. is more popular with the public than it has been since September, 2010, according to the Kaiser Health tracking poll. And during the recent congressional recess, many Republicans were faced with protests from constituents at town-hall meetings across the country. All of this has emboldened Democrats, especially those, like Senator Chuck Schumer, who have been around long enough to see health-care reform frustrate the ambitions of several Presidents.

I predict the discord in their party will grow as Republicans return to Washington after this last week of angry town halls, Schumer said in remarks at the National Press Club yesterday. I believe the odds are very high we will keep the A.C.A. It will not be repealed.

In their history of health-care reform, Blumenthal and Morone conclude with eight conditions necessaryfor passing major reform. The first, and perhaps most important, is passion.

Major health care reform is virtually impossible, difficult to understand, swarming with interests, powered by money, and resonating with popular anxiety, they write. The first key to success is a president who cares about it deeply. Any President who is just learning the basic fact that health care is complicated has failed the passion test. And without that, little else matters.

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Donald Trump Learns That Reforming Health Care Is Complicated - The New Yorker

Will he pass it? (Spoiler: probably not.)

President Donald Trump speaks at the Republican congressional retreat in Philadelphia on January 26, 2017. (AP Photo / Matt Rourke)

Donald Trumps address before a joint session of Congress on Tuesdayhas taken on added significance in the past 48 hours, for the simple reason that his agenda is falling apart in Congress, in a way that can only be rebuilt by qualities Trump has yet to exhibit in his presidency primarily, coalition-building around specific details.

First of all, the Affordable Care Act overhaul continues to flounder. After a leaked draft of the House Republican repeal and replace bill went public, hardline conservatives immediately attacked it, likely leaving the package short of the required votes. Freedom Caucus Chairman Mark Meadows and Mark Walker, chair of the Republican Study Committee, whose membership includes two-thirds of the Republican caucus, rejected the use of refundable tax credits as an entitlement expansion. They also dont like the tax on employer health care plans used to pay for it.

This is the main method of delivering insurance premium support in the plan, so effectively Meadows and Walker were saying no to the replacement. The House replacement isnt exactly generous its mostly a transfer from poor to rich so if conservatives cant get behind that, they cant get behind anything. Senate hardliners Ted Cruz, Rand Paul and Mike Lee similarly condemned anything other than the full repeal in the 2015 reconciliation package vetoed by President Obama (which was not full repeal, by the way, but lets move on).

This has left a desperate Paul Ryan considering putting forward the very repeal and delay package that Republicans in Congress and the President already rejected. The theory goes that no Republican would vote against a straight repeal (oh yeah, just watch them), and the details can be hashed out later. This is precisely where we were at the beginning of the Congress, so two months of wrangling has led nowhere. Its an admission of failure more than anything.

For Ryan, getting repeal out of the way is critical because its the first domino in a sequence that includes tax reform. Because repealing the ACA cuts a bunch of taxes on the rich and sets a lower revenue baseline, it affords Republicans the opportunity to cut taxes more heavily. So tax reform is stuck without a decision on health care. And by the way, tax reform is completely fractured as well, with retailers and manufacturers and their Congressional allies at each others throats over the controversial border adjustment tax on imports.

Normally in these situations, a presidential speech before Congress is just what the doctor ordered. The president can set the agenda and build a path for his party to follow. This is actually what Congressional Republicans want. At the end of the day, the most powerful voice is going to be the presidents, Rep. Mike Kelly (R-PA) said in a plea for the White House to smooth over tax reform. What the president can say is that the plan that gets presented to the conference is the one you need to vote yes on, added Rep. Bill Flores (R-OK), talking about Obamacare.

So lets get this straight. A group of hundreds of professional politicians whove been waiting for years to take total control of government are hinging their future success on what Donald Trump says in a speech?

Have they seen his speeches?

Trump is just not constitutionally equipped to bust out a detailed set of instructions for Republicans to follow. Hes more of an ideas guy (setting aside the quality of the ideas). Saying Nobody knew health care could be so complicated and walking away from the podium isnt going to resolve anything.

Now lets be clear: Republicans dont actually have to be told how to vote by someone who had todetermine whether Snooki should stay in the boardroom a couple years ago. Members of Congress look to the president to dictate events because theyre too cowardly to press their own ideas. They want Trump to use his political capital and provide cover for them.

The stakes are higher now than ever. Get The Nation in your inbox.

But this is just not a core competency for Trump. He relies on vagaries so he can be all things to all people. Hes contradicted himself on health care and taxes numerous times. His staff appears as torn about these high-profile issues as Congress is. The president and his top health care advisor, HHS Secretary Tom Price, have alternately said they will and wont be writing a legislative blueprint. The same ambiguity exists on taxes. These issues have been hanging out for months and Trump hasnt taken clear positions. Indeed, early indications are tonights speech will be high level and without details which will fail to arrest the slide into legislative irrelevancy.

And even if Trump broke with tradition and delivered a Clinton-esque bullet-point agenda tonight, Republicans begging for clarity will suddenly become all bent by things being so clear. Take for example the one area where the Trump White House is required to offer a formal blueprint: the budget. Trump announced a $54 billion increase in military spending, offset by cuts to domestic programs (or just a revved-up economy, depending on what day you listen to Trump). Immediately, Republicans objected, in the time-honored tradition of pronouncing a presidential budget dead on arrival. I am not one who thinks you can pay for an increase in [military] spending on the backs of domestic discretionary programs, said Rep. Charlie Dent (R-PA). Other pain caucus types are angered that the request doesnt address larger programs like Medicare, Medicaid, or Social Security. And even the military hawks think the $54 billion boost isnt enough!

The moral to the story is that Republicans dont want to be responsible for governing, and also dont want to be dictated to in governing. I think they liked it better when they took a lot of recesses, as long as there arent any town halls.

This fairly toxic environment makes pulling off tonights speech tricky for even the most polished orator. And thats not who will step to the podium tonight, with practically his entire legislative agenda at stake.

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Donald Trump Faces an Enormous Test Tonight - The Nation.

New York Times

Donald Trump, Oscars, George W. Bush: Your Tuesday Briefing New York Times President Trump will address Congress around 9 p.m. Eastern today, with a speech intended to outline his budget demands and set the course for his near-term policy agenda. He laid out a proposal on Monday that would increase military spending by $54 ...

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Donald Trump, Oscars, George W. Bush: Your Tuesday Briefing - New York Times

President Donald Trump signs H.R. 225 in the Oval Office of the White House, in Washington, D.C. on Feb. 28, 2017. Joshua RobertsReuters

President Donald Trump on Tuesday issued an executive order targeting a rule expanding federal oversight of the country's waterways, the latest in a string of actions targeting Obama-era environmental regulations.

Trump's executive order fulfills a campaign promise to undo the 2015 Waters of the U.S. rule, but does not immediately eliminate the measure. Instead, Trump directed the Environmental Protection Agency (EPA) and the Army Corps of Engineers to "review and reconsider" the rule. That process may take multiple years and touch off a legal fight that could last even longer.

The Waters of the U.S. rule allows the federal government to regulate pollution in a vast number of rivers, streams, lakes and other waterways that flow into the nation's major bodies of water. Opponents of the measure, which include agricultural interests, energy companies and many Congressional Republicans, say it threatens economic growth and grants the federal government too much authority.

Shortly before signing the order, Trump called the rule "one of the worst examples of federal regulation," and claimed that "the EPAs regulators are putting people out of jobs by the hundreds of thousands.

Environmental groups criticized the order as a threat to clean drinking water. "The rule protects the drinking water of 1 in 3 people living in this country, including those who voted for President Trump," said League of Conservation Voters Legislative Representative Madeleine Foote in a statement . "Dismantling these clean water protections will put safe drinking water at risk."

In the executive order, Trump instructs the EPA and Army Corps of Engineers to rely on a 2006 opinion from Supreme Court Justice Antonin Scalia for guidance on how to determine which waterways fall under the jurisdiction of the Clean Water Act, the legislation under which the waters of the U.S. rule was issued, according to an Axios report .

The move is Trump's latest attempt to change the federal government's approach to energy and the environment. In his first weeks, he moved to revive the Keystone XL pipeline and expedite construction of the Dakota Access Pipeline using an executive order. He has also reversed environmental regulations, including a rule preventing miners from dumping waste into streams, using resolutions passed under the Congressional Review Act.

Tuesday marked the first time Trump has used an executive order to target a rule that has already taken effect, which sets off its own complicated review process. He is also expected to target the Clean Power Plan , Obama's chief measure for fighting climate change, with a similar executive order in the coming days.

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What President Trump's New Order Means for Clean Water - TIME

President Donald Trump on Tuesday dodged responsibility for a botched mission he ordered in Yemen last month, placing the onus on the military and Barack Obamas administration instead.

Bill Owens, the father of Chief Petty Officer William Ryan Owens, the Navy SEAL who died in the operation, demanded an investigation into his sons death over the weekend. Owens further revealed he couldnt bear to meet Trump at the airportas Ryans casket was carried off the military plane last month.

Asked about the matter during an interview with Fox News Fox n Friends, Trump repeatedly said they were responsible for the outcome of the mission, in reference to the military.

This was a mission that was started before I got here. This was something they wanted to do, he said. They came to me, they explained what they wanted to do the generals who are very respected, my generals are the most respected that weve had in many decades, I believe. And they lost Ryan.

I can understand people saying that. Id feel Whats worse? Theres nothing worse, he added. This was something that they were looking at for a long time doing, and according to [Defense Secretary Jim] Mattis it was a very successful mission. They got tremendous amounts of information.

The raid yielded no significant intelligence,U.S. officials told NBC News on Monday. Earlier this month, however, Pentagon officials said it produced actionable intelligence. So, too, did White House press secretary Sean Spicer, who initially called the raid highly successful.

I think anyone who undermines the success of that raid owes an apology and [does] a disservice to the life of Chief Owens, he said earlier this month. The raid, the action that was taken in Yemen was a huge success.

Carlos Barria / Reuters

Presidents have traditionally accepted responsibility for their decisions, no matter the circumstances. President Harry Truman popularized the words, The Buck Stops Here and kept a sign of the phrase on his desk in the Oval Office. His successors took those words to heart, accepting ultimate responsibility in the wake of some of the nations biggest mishaps.

Im the president. And Im always responsible, President Barack Obama said in 2012 following an attack on a U.S. consulate in Benghazi, Libya, in which four Americans died.

In case you were wondering, in any of your reporting, whos responsible? I take responsibility, hesaidagain in 2010 after the Deepwater Horizon oil spill in the Gulf.

President George W. Bush in 2005owned up to his administrations failings in the wake of Hurricane Katrina, admitting that the federal government didnt fully do its job right. And he accepted responsibility for his costly decision to go to war with Iraq in 2003, despite faulty intelligence.

President Ronald Reagan in 1987 owned up to his administrations dealings amid what is known as the Iran-Contra scandal, telling the nation in a prime-time addressfrom the Oval Office that he took full responsibility for his administration.

As angry as I may be about activities undertaken without my knowledge, I am still accountable for those activities, he said. As disappointed as I may be in some who served me, Im still the one who must answer to the American people for this behavior. And as personally distasteful as I find secret bank accounts and diverted funds - well, as the Navy would say, this happened on my watch.

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Donald Trump Blames SEAL's Death On Military: 'They Lost Ryan' - Huffington Post