Executive orders, military actions, court rulings, protests, resignations and, of course, tweets. So many tweets. President Trump’s first 100 days have been a whirlwind, and it’s been hard to keep track of everything that’s happened and to figure out what’s really important. Below is our summary of where things stand 100 days into the Trump era on some of the nation’s most important policy issues.

Health care

The most significant development in health care policy during the first 100 days is what hasn’t happened: Trump hasn’t repealed the Affordable Care Act. And when it comes to enacting health care reform, the White House’s problem isn’t simply that Republicans haven’t gotten their act together before the 100-day marker. Rather, there may to be potentially insurmountable ideological differences within the Republican Party.

To step back a little: On March 6, House Speaker Paul Ryan released a bill, the American Health Care Act, that he touted as a plan to “repeal and replace” the ACA. Except that because the GOP doesn’t have the 60 votes it needs in the U.S. Senate for a full repeal, the new bill was really more of an addendum to the ACA that removes some pieces of the legislation and adds others. The bill would have peeled back the expansion of Medicaid, reduced subsidies for people buying insurance on the ACA’s private marketplaces, and reduced regulations on insurers, essentially gutting protections for people with pre-existing conditions — all of which ensured it would get no support from Democrats. In late March, Ryan pulled the bill when it became clear it didn’t have enough support from Republicans either and couldn’t pass the House.

Recently, the AHCA has been revived, with several amendments intended to win over the conservative House Freedom Caucus, which opposed the original bill. The changes worked: The Freedom Caucus this week said it would support the revised bill. But in catering to conservatives, Ryan and his allies may have lost support from moderates, and on Thursday they dropped efforts to pass the bill before Trump’s 100th day. Despite six years of trying to repeal and replace the Affordable Care Act, Republicans are currently at an impasse.

That’s not to say, however, that the GOP has accomplished nothing on the health care front since Trump took office. Quite the opposite. The Senate confirmed his pick to lead the Department of Health and Human Services, Tom Price, a former congressman from Georgia who was a vocal opponent of Obama-era health policy. Under Price, HHS has set about making changes to Medicaid and the health insurance marketplaces created by the ACA, pushing them in a more conservative direction. HHS has encouraged states to seek waivers that would allow work requirements for people who receive Medicaid, the health insurance program for low-income people, among other changes.

Finally, Trump has also likely destabilized the private health insurance marketplace, although most Americans won’t see that as an accomplishment, according to polling from the Kaiser Family Foundation, a health policy think tank. After double-digit premium increases in many places in 2017, the marketplaces in most states had largely stabilized before Trump took office, according to reports from the Congressional Budget Office, Kaiser Family Foundation and S&P (there are some notable exceptions to that stability). But companies may now flee the market because of uncertainty brought on by the political merry-go-round of attempts to repeal the ACA, mixed messages from the White House on its intentions for the marketplaces, and a threat to withhold payments the government is supposed to make to insurers. The White House agreed this week to fund the payments to insurers for 2018, which should help, but likely won’t fully address the cost of uncertainty. With insurers required to file their 2018 plans as soon as next week, it may be hard to recover from the chaos of the first 100 days. — Anna Maria Barry-Jester

Immigration

Border security and immigration policy were Trump’s biggest campaign platforms and the main issues he attempted to tackle immediately after taking office. Within his first week in office, the president signed his most controversial executive order to temporarily block travel from seven, then later six, predominantly Muslim countries and to suspend the nation’s refugee program. Chaos at national airports ensued as travelers were detained and a frenzy of protests erupted across the country. The following week, a federal judge in Seattle ordered a nationwide halt on the order and the 9th U.S. Circuit Court of Appeals upheld the decision, noting the states “raised serious allegations about religious discrimination.” A revised version of the order was ultimately blocked on similar grounds, and the future of the policy remains in limbo.

Trump’s other actions on immigration have gotten less attention than the travel ban, but they might ultimately be more consequential. He issued two other executive orders during his first week that focused on tougher border security and immigration enforcement within the U.S., which included the staple of Trump’s campaign — construction of a wall along the Mexican border. (Trump this week backed away from his demand that Congress provide funding for the wall as part of a government-funding bill.) Trump called for the hiring of 5,000 Border Patrol agents and 10,000 Immigration and Customs Enforcement officers to stop millions of dangerous criminals he says are coming into the U.S. through the Mexican border — even though illegal immigration has fallen sharply in recent years and research finds that immigrants are less like to commit violent crimes than U.S. citizens.

Trump’s policies represent a reversal of the approach taken by Obama toward the end of his last term, when he directed immigration authorities to prioritize gang members, convicted felons and people who posed a threat to national security. Trump’s order reset those priorities, resulting in a significant increase in ICE arrests from this time last year. But despite the spike in arrests, it could be years before detainees are deported or even see an immigration judge due to the backlog of over 500,000 pending cases. Trump has said, however, that his administration is not targeting so-called DREAMers — people who entered the country illegally as children — and he has left in place for now Obama’s Deferred Action for Childhood Arrivals program, which offered protection to some of them.

Trump’s policies may be having an effect even before they are fully in place, however. The Department of Homeland Security has reported a notable decline in apprehensions at the border, which Trump attributed to his new policies. And there is evidence that despite the court rulings blocking it, Trump’s travel ban negatively impacted U.S. tourism and led to colleges receiving significantly fewer applications from international students for the fall. — Kathryn Casteel

Economic policy

With the possible exception of immigration, no issue was more central to Trump’s presidential campaign than the economy. He promised to bring back manufacturing and coal-mining jobs, crack down on outsourcing, renegotiate trade deals and reverse “job-killing regulations.” Rhetorically, Trump has continued to stress economic issues since taking office. He has repeatedly invited CEOs to the White House, touted the strong jobs numbers released on his watch and publicly flirted with withdrawing the U.S. from NAFTA. (This week he said he won’t — for now.)

In terms of concrete action, however, Trump’s economic policy has gotten off to a slow start. He hasn’t introduced the infrastructure package he promised on the campaign trail. His tax plan, released this week, is so light on details that analysts haven’t even been able to estimate its effects. In other cases, he has explicitly reversed positions taken on the campaign trail: He reneged on a promise to label China a “currency manipulator,” and dropped his criticism of the Import-Export Bank. His proposed budget outline would eliminate programs meant to boost the economy in some of the rural areas that helped him win the White House.

Trump has taken some actions on the economy. He formally withdrew from the Trans-Pacific Partnership, a largely symbolic move but one that fulfilled a campaign promise. This week he slapped tariffs on imports of Canadian lumber. And, most significantly, he has rolled back a series of Obama-era regulations that businesses argued restrained hiring.

On those few economic policy actions, moreover, Trump hasn’t governed much like the populist he sounded like at campaign rallies. Perhaps that isn’t surprising given the makeup of his economic team. National Economic Council Director Gary Cohn, who has emerged as Trump’s most influential economic adviser, is the former president of Goldman Sachs. Treasury Secretary Steven Mnuchin is another Goldman alumnus, while Commerce Secretary Wilbur Ross Jr. is a billionaire investor. Trump’s nominee to chair the Council of Economic Advisers, Kevin Hassett, is a mainstream conservative. None are likely to push Trump toward radical populism. — Ben Casselman

Criminal justice

One of Trump’s boldest (and most controversial) appointments was naming Jeff Sessions as attorney general. Much of the federal government’s impact on criminal justice is centralized within the Justice Department, and Sessions is a hard-liner, articulating a tough-on-crime approach to match what he’s called a “dangerous permanent trend” of rising crime. (Contrary to Sessions’s claim, FBI data shows that both overall crime and violent crime remain low, although murder, specifically, has risen sharply for the past two years.) Supporters hoped — and critics feared — that Sessions would reverse Obama-era criminal justice reforms such as increasing oversight of police departments, ending the use of private prisons and imposing lighter sentences for some nonviolent drug crimes. Despite Sessions’ appointment, however, Trump and the Justice Department have struggled to make major changes so far.

Sessions’ views contrasted most dramatically with Obama in regards to police oversight. Obama’s Justice Department was extremely active in investigating local police departments and forcing them to change practices the administration viewed as violating the Constitution. In contrast, Sessions and Trump believe that some police reform agreements constitute “harmful federal intrusion,” which can reduce morale and decrease proactivity.

Justice Department attorneys have tried to get one consent decree (in Baltimore) put on hold, but they were stymied by a federal judge. Sessions has also ordered a review of all current reform agreements, but most are already in place and would require the cooperation of a judge to dismantle. At best, Sessions may only be able to stop further federal police oversight, instead of reversing Obama’s efforts.

Sessions has also tried and failed to discourage “sanctuary cities,” which restrict cooperation between their police departments and the federal government’s immigration authorities. Since many immigrants live in such cities, their lack of coordination with Immigration and Customs Enforcement is a major thorn in the side of politicians like Trump who favor more deportation.

In an effort to encourage compliance with ICE, Sessions and Trump have threatened to pull federal funding from sanctuary cities’ police departments. But, as with consent decrees and the travel ban, the courts halted Trump’s efforts. A federal judge in California found that the Justice Department cannot withhold funds from sanctuary cities. Sessions said the Justice Department would fight the ruling; in the meantime, it is unclear what other leverage the Trump administration has to push for compliance.

Many of the most significant effects of Sessions’ policies within the sphere of criminal justice won’t be immediate. For example, changes to enforcement priorities — Sessions has promised to focus especially on criminal immigrants and international cartels — won’t be measurable in the aggregate for some time. It’s possible that Trump’s policies will be implemented slowly, through alterations to staffing and funding. But in the first 100 days, federal judges have repeatedly blocked some of the most aggressive elements of Trump’s criminal justice agenda. — Rob Arthur

The environment

The environment was never a major part of the Trump campaign. Its official website didn’t contain any environmental position statements. But Trump did make campaign promises relating to the environment, especially about energy and climate change. Both the promises of candidate Trump and the actions of President Trump have tended to follow a few big themes: actions aimed at aiding the fossil fuel industry, actions aimed at favoring the concerns of businesses over the concerns of environmental groups, and actions aimed at undoing the would-be environmental legacy of Obama. These three themes are highly intertwined and, in the first 100 days, Trump has made headway on all of them.

For instance, his executive actions have included the end of an Obama moratorium on coal mining on federal lands; reversing a rule from Obama’s Department of the Interior that would have increased restrictions on dumping mining waste into streams; and rescinding Obama’s Clean Power Plan, a series of regulations that would have made it harder to operate and build new coal-fired power plants. It’s hard to know what this will mean in the long term — if these 100 days have taught us anything about the environment, it’s that executive orders made by one president can be easily reversed by the next — but Trump has come out of the gate with a string of decisions that will affect the environment for the course of his term in office, and perhaps beyond. Many scientists think that the reversal of the Clean Power Plan, in particular, could make it all but impossible for the U.S. to meet its obligations under the climate agreement signed in Paris in 2015. (The administration is still waffling about whether or not it will back the country out of that agreement entirely.)

One major part of shaping that future: Trump’s proposed budget for the Environmental Protection Agency, which would cut the agency’s funding by 31 percent compared to last year. To achieve that goal, the EPA has proposed scaling back enforcement and monitoring, eliminating numerous programs and grants to states, and cutting just about everything having to do with climate change — including U.S. contributions to the Global Climate Change Initiative. It’s unlikely the final 2018 budget will perfectly match the proposed one, but as the starting point for negotiations, it looks very different than past administrations’ budgets. That makes it likely that Trump will fulfill his campaign promise of reducing the power of the EPA. — Maggie Koerth-Baker

Foreign policy

Shifts in foreign policy typically play out over years, not months. So it’s hard to grade Trump’s approach on these issues — or even determine his exact vision on foreign affairs — based on just 100 days. But there are a few signs of where the president wants to take American national security policy.

During his campaign, Trump promised to “bomb the s–” out of ISIS, and all indications are his administration is doing so. Some military officials have suggested privately that Obama and his White House advisers were too involved in the planning and execution of strikes against suspected terrorists. Trump, according to published reports, is not asking for as much consultation as his predecessor and letting the military act on its own. In fact, the commander-in-chief does not seem to have been informed before the U.S. used America’s most powerful non-nuclear bomb to hit an alleged ISIS complex in Afghanistan.

Trump’s approach may be raising a new concern: There is some evidence that the number of civilians killed by U.S. antiterrorism airstrikes in the Middle East is rising. Trump personally approved a January raid of a village in Yemen aimed at some members of Al-Qaeda in the Arabian Peninsula who were there. Yemeni civilians died in the raid, although there is some dispute about how many. (The Washington Post, citing Yemeni officials, put the number at 31, while U.S. military officials said it was between four and 12.) A U.S. Navy Seal was also killed in the mission, which U.S. officials said resulted in obtaining hard drives and other material related to AQAP’s operations.

Trump’s administration is implementing a few of his core campaign promises on foreign policy: demanding European leaders spend of more their budgets on defense, pulling the U.S out of the Trans-Pacific Partnership, strongly defending Israel and trying (so far unsuccessfully) to bar travelers from some majority-Muslim nations from entering the U.S..

But on a number of different issues, Trump’s foreign policy is markedly different from his campaign. He had suggested that he would be tough on China, labeling the world’s largest nation a currency manipulator, while trying to build a strong alliance with Russia. Instead, Trump’s national security team has repeatedly criticized Russia, while Trump has courted Chinese president Xi Jinping and backtracked from the currency issue. He also authorized an attack on Syria for its use of chemical weapons, after downplaying the value of military action in the Middle East during his campaign, although he has so far avoided drawing the U.S. more deeply into the Syrian conflict.

North Korea has been in the headlines throughout Trump’s first 100 days. The administration has talked tough about stopping North Korea’s missile program, but so far its main policy, encouraging China to push the North Koreans away from further developing its weapons program, is similar to the Obama administration’s approach.

Overall, it’s not clear so far that Trump has some broader foreign policy doctrine or even a consistent approach. Well, he may have one doctrine: In a speech in April 2016, the future president said that America needed to be “more unpredictable” in its national security approach. Mission accomplished. — Perry Bacon Jr.

CORRECTION (April 28, 12:06 p.m.): A previous version of this article incorrectly identified the judge who blocked Trump’s policy on sanctuary cities. The ruling was by a judge in the Northern District of California, not the 9th Circuit Court of Appeals.