His approach to Medicare savings is different from one proposed by House Republicans to transform the program. He'd cut Medicare payments to service providers and is proposing that a growing share of seniors pay higher premiums over time, based on their incomes. Such Medicare changes were foreseen before the 2012 election. Meantime, Washington is expanding Medicaid to bring in more of the low-income uninsured.For years, budget hawks have insisted that huge entitlements must be on the table for true fiscal discipline to be achieved. They're on the table now. ___ Gay rights: The promise: Be a "fierce advocate" for gay rights. Obama endorsed gay marriage in 2012. ?Prospects: The course for gay marriage will be shaped by the Supreme Court, expected to rule on the matter in June. It's allowed in 10 states and the District of Columbia; many other states seem unlikely to follow suit unless forced by Congress or the court. But cultural attitudes are changing, as did Obama's views. His administration argued in favor of gay marriage rights to the court. It seems unlikely the court will order gay marriage to be legalized in all states but its ruling could help same-sex married couples on estate taxes, Social Security benefits and other tangible matters. In his first term Obama lifted the ban on gays serving openly in the armed forces. ___ Global warming: The promise: "Continue to reduce the carbon pollution that is heating our planet." Prospects: Obama probably will take more steps to reduce the pollution blamed for climate change, but they are unlikely to be of the scale needed to help much in slowing the heating of the planet. Any policy to reduce heat-trapping pollution will target coal burned by power plants and oil refined for automobiles; those industries have powerful protectors in both parties.