According to Paul Ryan, he has six top priorities for the upcoming year:
Regulatory relief….Obamacare relief….reforming the tax code….foreign policy, rebuilding the military….securing the border….And then while we work on that, we want to work on poverty and restoring our constitutional separation of powers….So those are effectively the six pieces that we’ve been talking about.
I have a couple of comments about this. First, there’s nothing here about entitlement reform, or Medicare reform in particular. This doesn’t mean Medicare is safe forever, but it does suggest it’s 
not a briar patch Ryan wants to jump in right away.
Second, these are all really, really complex. Regulatory relief—whatever that actually means—is dauntingly complicated. Repealing Obamacare is all but impossible without Democratic support, which means months or years of negotiation. Tax cuts are easy, but Ryan seems to want wholesale tax reform on the 1986 model, which has a ton of moving parts. Securing the border is a lot more than just building a wall. And “working on poverty”—I shudder to think what he means by this—is obviously no cakewalk.
On the bright side, rebuilding the military is fairly easy. You just give them more money and hope it doesn’t go down a rat hole.
If Ryan is serious about this stuff, he’s mapped out two years of work already—and that’s not even counting whatever Donald Trump wants to throw in the mix. Put it all together, stir in Trump’s promise not to touch entitlements, and I suspect that we’re not going to see any serious movement on Medicare for at least a year, maybe more.
