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Having approved a tax bill, Republicans in Congress consider what to do in the election year of 2018. Senate Majority Leader Mitch McConnell indicated one thing that is not next. He tells NPR News that he'd rather not try again to repeal and replace Obamacare; other Republicans disagree. Republicans also differ on how to approach big programs like Medicare, Medicaid and food stamps. Here's NPR national political correspondent Mara Liasson.
MARA LIASSON, BYLINE: House Speaker Paul Ryan had two lifelong goals. The first one, overhauling the tax system, he accomplished this week. The second one he told radio talk show host Ross Kaminsky he's ready to tackle in 2018.
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PAUL RYAN: In the next year, we're going to have to get back at entitlement reform. And frankly, it's the health care entitlements that are the big drivers of our debt.
LIASSON: Longtime advocates of reforming health care entitlements, otherwise known as Medicare and Medicaid, say the tax debate actually made entitlement reform harder, not easier. Maya MacGuineas is the president of the Committee for a Responsible Federal Budget.
MAYA MACGUINEAS: Entitlement reform is an important objective that undeniably needs to be addressed. But by having it suddenly be the focus of attention right after a big budget-busting tax cut, now it looks like it's a big pay floor for a tax cut that we couldn't afford. And after a tax bill that in many ways has benefited the people at the upper end of the spectrum, I think it's going to be a harder sell that now the savings on the spending side should come from low-income people.
LIASSON: And there are other hurdles. Ryan isn't getting much cooperation from the other side of Capitol Hill since Senate Republican leader Mitch McConnell says he doesn't want to push more big pieces of social legislation with Republican-only votes. And after the partisan vote on tax cuts, says MacGuineas, no Democrats want to talk about entitlement reform.
MACGUINEAS: We started with making the situation worse through partisan tax cuts, and now the legitimate objective of fixing entitlements is going to be so polarizing that there's no way that we're going to get everybody to the table to do a big debt deal to actually fix this problem.
LIASSON: Another hurdle is the president of the United States. Donald Trump famously promised during the campaign not to cut entitlements.
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PRESIDENT DONALD TRUMP: Save Medicare, Medicaid and Social Security without cuts - have to do it.
LIASSON: White House aides say Trump wants to keep his promise not to touch the big middle-class entitlements - Medicare and Social Security - but he is interested in reforming means-tested programs that target lower income Americans, programs the president calls welfare. Paul Winfree, who recently left the White House Domestic Policy Council, told a Heritage Foundation conference back in November that this is a top priority for the president.
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PAUL WINFREE: It's something that excites him. It's something that he has a lot of energy about. We have gone in there several times to talk to him about things that have absolutely nothing to do with welfare reform. And as the president has been known to do, he completely changes the topic and says that he wants to instead talk about welfare reform in some capacity.
LIASSON: The president, who often uses big rallies the way other politicians use focus groups, has been talking about this on the stump.
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TRUMP: Welfare reform - does anybody want welfare reform?
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LIASSON: Those big cheers, say White House officials, tell the president just how important this issue is to his base.
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TRUMP: I know people that work three jobs, and they live next to somebody who doesn't work at all. And the person who's not working at all and has no intention of working at all is making more money and doing better than the person that's working his and her ass off, and it's not going to happen - not going to happen.
LIASSON: Donald Trump isn't the first Republican to disparage people who get government assistance. There were Paul Ryan's makers and takers, Mitt Romney's 47 percent and Ronald Reagan's Cadillac-driving welfare queen.
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RONALD REAGAN: In Chicago, they found a woman who holds the record. She used 80 names, 30 addresses, 15 telephone numbers to collect food stamps, Social Security, veterans benefits.
LIASSON: That was back in the '70s and '80s, the time when Donald Trump was forming many of his bedrock political views. Budget expert Stan Collender says things are different now.
STAN COLLENDER: This is vintage '80s Ronald Reagan politics. But there's been 30 or 37 years since Ronald Reagan was president, and a lot has changed.
LIASSON: First of all, only about a million and a half families currently get traditional welfare, what's called TANF - Temporary Assistance for Needy Families. More people rely on Medicaid, and that's one of the reasons why Republican efforts to cap expenditures for Medicaid failed this year. White House aides say they are now looking at a number of additional changes, including tighter work requirements and drug-testing rules for food stamps, Medicaid and housing assistance. Those changes may not save much money the way changes in the big middle-class entitlements like Medicare or Social Security might. But it will help the president highlight an issue that seems to motivate his base in a year when getting Republican voters excited is the No. 1 goal.
Mara Liasson, NPR News, Washington. Transcript provided by NPR, Copyright NPR.
