President Donald Trump’s administration is now embroiled in an all-consuming fight with the Hill over immigration, and there’s no guarantee that its push for an infrastructure plan will go anywhere — but a robust agenda that covers everything from entitlements to oil exploration is bubbling up from below.

While the Obama administration infamously micromanaged policy from the West Wing, the Trump White House has given Cabinet secretaries and agency chiefs almost total freedom to do what they want, according to two close advisers to the White House.


Since the start of the year, the Centers for Medicare and Medicaid Services has quietly opened the door to sharply limiting Medicaid; DHS has revoked a special immigration status for Salvadorans; and the Department of Interior has moved to open up federal land to offshore drilling.

“When you have knowledgeable and experienced people who know what they want to do, and are given running room from the White House to do what they want to do, you can get a lot done and get it done quickly,” said Tevi Troy, CEO of the American Health Policy Institute and former deputy secretary of HHS under President George W. Bush.

After Trump’s inauguration in 2017, the agencies took time to ramp up. The Trump transition team did not have a government-in-waiting ready on Jan. 20, and the confirmation process also took much longer than in previous administrations, given the hunt for qualified personnel, some nominees’ complicated financial portfolios, and the slow pace of confirmation votes in the Senate.

A year later, the policymaking at several agencies is starting to jell, moving at a faster clip than any policy emerging from the White House, according to 10 policy experts, close advisers to the White House and former administration officials.

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CMS, headed by close Vice President Mike Pence ally Seema Verma, dramatically tweaked Medicaid recently by beginning to allow states to impose work requirements on some recipients — a longheld goal of conservatives that starts to chip away at the program that forms the backbone of Obamacare.

“The notion of instilling work requirements for Medicaid has long been a conservative policy priority,” said Lanhee Chen, a fellow at the Hoover Institution and former policy director for the Romney-Ryan presidential campaign in 2012. “All of this is happening with the blessing of the White House. It illustrates how widespread policy changes might be at the administrative level in the coming years.”

A White House spokesman did not respond to a request for comment.

HHS also unveiled a proposed rule to overhaul its civil rights office and offer protection to health workers who do not want to perform services like abortion or treat transgender patients because of religious or moral reasons.

Over at the EPA, Administrator Scott Pruitt has been aggressively rolling back parts of the Obama era’s environmental legacy, including a proposed ban on a pesticide that scientists say adversely affects people’s health.

The Education Department, under Secretary Betsy DeVos, rescinded the Obama-era guidance on how schools should handle sexual assault, and the FCC voted to end so-called net neutrality rules that prevented large internet providers like AT&T from slowing internet traffic to some websites. That latter decision now faces a court challenge from 21 states and several public interest groups.

DHS opted to revoke the temporary protected status of 200,000 people from El Salvador who have legally lived and worked in the U.S. following a devastating earthquake in 2001 in that country. Similarly, in November, the Trump administration ended the special immigration status for Haitians. Combined, these moves advance the Trump campaign agenda of getting tougher on immigration.

Meanwhile, Scott Gottlieb at the FDA has accelerated the process to approve generic drugs — even though he has been in his position only since May.

Tally it, and it adds up to a significant, far-reaching portfolio of ways the Trump administration is tweaking the federal government, even though the individual steps are not as dramatic as, say, passing a huge tax bill.

“Once you get past the Twitter feed and all of the emotional stuff related to the Mueller investigation and the president’s outbursts about reporters and foreign countries, it is actually operating like a real administration and starting to get things done,” said Jay Lefkowitz, director of Cabinet affairs under President George H.W. Bush and deputy assistant to the president for domestic policy and general counsel of the Office of Management and Budget under President George W. Bush.

In some instances, the president has been more than happy to take credit for what his agency heads are doing. After Interior Secretary Ryan Zinke decided to slash the size of two national monuments in Utah, the president flew to Utah to tout the move.

“Your timeless bond with the outdoors should not be replaced with the whims of regulators thousands and thousands of miles away,” Trump said in his Utah speech.

“I’ve come to Utah to take a very historic action to reverse federal overreach and restore the rights of this land to your citizens,” he later added.

The agencies have taken on an outsize importance in part because Congress has struggled to pass major legislation. But some note that lawmakers’ inability to agree on a budget has in some ways held agencies back from making even more radical changes.

That’s true at the Department of Labor, where the Trump administration’s budget proposed cutting spending by roughly 21 percent — a move that Secretary Alexander Acosta has not yet been able to enact under Congress' temporary funding bills.

“The challenge at a place like the Department of Labor is that significant cuts would have changed direction of the agency, but under some version of a continuing resolution, the Labor Department has not been able to act on those cuts,” said Chris Lu, former deputy secretary of labor and former White House Cabinet secretary to President Barack Obama.

Close advisers to the White House say that 2018 will be the year of deregulation through the agencies, with Cabinet officials and political appointees receiving guidance from Neomi Rao, administrator of the Office of Information and Regulatory Affairs, and legal assistance from the White House counsel’s office.

Since many deregulatory moves will face court challenges that could take years, advisers urge the administration to act quickly so decisions come down by 2020, the next election year.

“Deregulation is one of the Trump administration’s highest priorities, so you can expect many of the Cabinet departments and agencies to be launching their own agendas in that area this year,” said Leonard Leo, executive vice president of the Federalist Society, a conservative group devoted to limited government. “Expect many of those agencies and departments to be proposing new rules, or proposing to revoke old rules. That is the next step in this deregulatory revolution.”

Given the Republicans’ one-vote margin in the Senate, it seems unlikely that the White House can notch another big legislative victory along a party-line vote like tax reform, so it forces the administration to turn to seemingly smaller victories.

“In some ways, it happened a little faster than it did under Obama — this move to the pen and a phone,” said Troy, about the way the Trump administration will use agencies and executive power to pass its goals. “The recognition has set in sooner about the realities.”