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Republicans have failed to re-peal and replace the AffordableCare Act. Now, can it be repaired?

The seven-year-old law has sur-vived Supreme Court decisionsand aggressive attempts to extin-guish it by Republicans in Con-gress and the White House. Buteven people who rely on its cover-age agree that it still has big prob-lems. The question for the roughly20 million Americans who buytheir own health coverage — andfor millions of others who remainuninsured — is what can realisti-cally be done to address theirmain concerns: high prices andlack of choice in many parts of thecountry.

“Everyone feels reallyscrunched by the prices we’repaying, and we have no options in

Iowa,” said Catalina Ressler, 39, apsychologist outside Des Moineswho pays $1,567 in monthly premi-ums. “Next year is going to beeven worse.”

Ms. Ressler’s plan, which cov-ers her family of four, also comeswith a $7,000 deductible. Their in-surer, Wellmark Blue Cross andBlue Shield, is pulling out of theAffordable Care Act marketplacein Iowa next year, leaving just onecompany, Medica, to possibly re-main.

Citing the protracted uncer-tainty over the law’s future, manyinsurers have proposed big rateincreases again for next year eventhough many are no longer incur-

How to Repair the Health Law(It’s Tricky but Not Impossible)

This article is by Reed Abelson,Abby Goodnough and Katie Thom-as.

Continued on Page 14

WASHINGTON — PresidentTrump enters a new phase of hispresidency on Monday with a newchief of staff but an old set of chal-lenges as he seeks to get back oncourse after enduring one of theworst weeks that any modern oc-cupant of the Oval Office has expe-rienced in his inaugural year inpower.

With his poll numbers at his-toric lows, his legislative agendastalled and his advisers busy plot-ting against one another, Mr.Trump hoped to regain momen-tum by pushing out his top aide,Reince Priebus, and installing aretired four-star Marine general,John F. Kelly, to take command.But it is far from certain that themove will be enough to tame adysfunctional White House.

The shake-up followed a weekthat saw the bombastic, with-me-or-against-me president defied asnever before by Washington andits institutions, including Republi-cans in Congress, his own attor-ney general, the uniformed mili-tary leadership, police officersand even the Boy Scouts. No long-er daunted by a president with aTwitter account that he uses like aGatling gun, members of his own

party made clear that they wereincreasingly willing to standagainst him on issues like healthcare and Russia.

The setbacks came against thebackdrop of a West Wing at warwith itself, egged on by a presidentwho thrives on conflict and chaos.Mr. Kelly, who had been serving assecretary of homeland security,brings a career of decisive leader-ship to his new assignment asWhite House chief of staff. But heconfronts multiple power centersamong presidential aides, all withindependent lines to the man inthe Oval Office who resists the dis-cipline and structure favored bygenerals.

“Everybody knows what needsto be done to fix it, and I think ev-erybody is coming to accept thatthey’re not going to happen,” saidSara Fagen, a White House poli-tical director under PresidentGeorge W. Bush. “And the reasonthey’re not going to happen is theperson at the top of the food chainis not going to change. This is thenew normal. This goes down asone of the worst weeks he’s hadpolitically and P.R.-wise, but I

President Tries to Regroup As West Wing Battles Itself

Facing Hurdles After a Staff Shake-Up andRising Defiance by His Own Party

By PETER BAKER

Continued on Page 16

LAIKIPIA, Kenya — The two elders,wearing weather-beaten cowboy hatswith the strings cinched under their chins,stood at the edge of an empty farm, cover-ing their mouths in disbelief.

Their homes — neat wooden cabins —had been smashed open. All their cattlehad been stolen. So had their chickens.House after house stood vacant, withoutanother soul around. It was as if somehuge force had barreled into the villageand swept away all the life.

Sioyia Lesinko Lekisio, one of the eld-ers, had no doubts who did this. Swarms ofherders from another county had invaded,attacking any farm or cattle ranch in theirpath, big or small, stealing livestock, ran-sacking homes and shooting people withhigh-powered assault rifles.

“There’s nothing we can do about it,” hesaid. “They want our land.”

Kenya has a land problem. Africa itselfhas a land problem. The continent seemsso vast and the land so open. The awe-some sense of space is an inextricablepart of the beauty here — the unadulter-ated vistas, the endless land. But in a way,that is an illusion.

Population swells, climate change, soildegradation, erosion, poaching, globalfood prices and even the benefits of afflu-ence are exerting incredible pressure onAfrican land. They are fueling conflictsacross the continent, from Nigeria in thewest to Kenya in the east — including herein Laikipia, a wildlife haven and one ofKenya’s most beautiful areas.

Large groups of people are on the move,desperate for usable land. Data from

NASA satellites reveals an overwhelmingdegradation of agricultural land through-out Africa, with one recent study showingthat more than 40 million Africans are try-ing to survive off land whose agriculturalpotential is declining.

At the same time, high birthrates andlengthening life spans mean that by theend of this century, there could be as manyas four billion people on the continent,about 10 times the population 40 yearsago.

It is a two-headed problem, scientistsand activists say, and it could be one of thegravest challenges Africa faces: The qual-ity of farmland in many areas is gettingworse, and the number of peoplesqueezed onto that land is rising fast.

“It’s a looming crisis,” said Odenda Lu-

Herders displaced by conflict graze their livestock on others’ pastures in Laikipia, Kenya, part of continentwide land issues.TYLER HICKS/THE NEW YORK TIMES

Disappearance of Fertile LandFuels ‘Looming Crisis’ in Africa

By JEFFREY GETTLEMAN

Continued on Page 10

Venezuela is on a collision course withthe U.S. as it votes on a radical plan toconsolidate leftists’ power — one thatcitizens aren’t allowed to reject. PAGE 9

INTERNATIONAL 4-11

Venezuelan Democracy at RiskIn a bold experiment, a Vermont utilityis helping customers power their homeswhile they are entirely disconnectedfrom the grid’s electricity supply. PAGE 1

SUNDAY BUSINESS

Vermonters Go Off the GridFinland, once formidable in traditionalsports, has pivoted to more bizarrecompetitions: Think swamp soccer andmosquito killing, for starters. PAGE 1

SPORTSSUNDAY

The Land of Wacky GamesAlisyn Camerota, who left Fox News forCNN, has set her breezy first novel at aright-leaning cable network, offering aninsider’s guide to a closed world. PAGE 1

SUNDAY STYLES

Satirizing the TV News Roger Cohen PAGE 1

SUNDAY REVIEW

U(D547FD)v+%!#!_!#!_

PARTY UNITY Senator ChuckSchumer holds Democrats togeth-er in the health care fight. PAGE 15

SEOUL, South Korea — SouthKorea announced Saturday that itwill soon start talks with theTrump administration about al-lowing Seoul to build more power-ful ballistic missiles to counter theNorth, but current and formerAmerican officials said the movewould have little effect on themost urgent problem facingWashington: North Korea’s ap-parent ability to strike Californiaand beyond.

The South’s newly elected pres-ident, Moon Jae-in, called for therelaxation of limits on its missilearsenal hours after the Northlaunched an intercontinental bal-listic missile, or ICBM, 2,300 milesinto space. Experts quickly calcu-lated that the demonstrated range

of that test shot, if flattened outover the Pacific, could easilyreach Los Angeles and perhaps asfar as Chicago and New York,though its accuracy is in doubt.

The new missiles that South Ko-rea wants, in addition to beingable to strike deep into the North,could be a way of pressuringChina to restrain Pyongyang be-cause the missiles would likely beable to hit Chinese territory aswell.

Mr. Moon’s top national securi-ty adviser, Chung Eui-yong, calledhis White House counterpart, Lt.Gen. H. R. McMaster, early onSaturday Seoul time to proposethat the allies immediately startnegotiations to permit South Ko-

To Counter North Korea, SouthSeeks U.S. Nod to Bolster Arms

By CHOE SANG-HUN and DAVID E. SANGER

Continued on Page 8

FREMONT, Calif. — After a me-teoric rise that made it, at leastbriefly, the most valuable car com-pany in America, Tesla arrived ata moment of truth on Friday nightas it delivered the first of its mass-market sedans to their new own-ers.

For a decade, the company has

been a manufacturer of high-endelectric cars in small numbers.But now, Tesla is aiming at muchloftier goals. It wants not only tobecome a large-scale producer inthe suddenly crowded field of bat-tery-powered vehicles but also tolure consumers away from main-stream, gasoline-powered auto-mobiles.

Yet Tesla’s expansion comeswith a set of risks. It plans to more

than quadruple its annual produc-tion to more than a half-million ve-hicles, while still maintaining itsimage as an enlightened outlier inan industry long dominated byglobal giants — who are racing todevelop electrified vehicles oftheir own.

Tesla unveiled its new Model 3sedans, starting at $35,000, in aceremony on Friday night on thegrounds of its sprawling assembly

plant and research facility outsideSan Francisco. To the cheers ofhundreds of employees and invit-ed guests, Tesla’s chief executive,Elon Musk, drove onstage in aModel 3 and heralded a new chap-ter in the company’s growth.

“The whole point of this com-pany was to make a really great,affordable electric car,” said Mr.Musk, a Silicon Valley billionaire

Tesla Delivers a Mass-Market Car. Can It Upend an Industry?

By BILL VLASIC

Tesla’s Model 3 sedans at its plant in Fremont, Calif., on Friday. Increasing capacity at the plant is one of Tesla’s biggest challenges.TESLA, VIA REUTERS

Continued on Page 13

Late Edition

VOL. CLXVI . . . No. 57,674 © 2017 The New York Times Company NEW YORK, SUNDAY, JULY 30, 2017

Today, sunshine, low humidity,warmer, high 81. Tonight, clear, low67. Tomorrow, sunshine and patchyclouds, a warmer afternoon, high 86.Details in SportsSunday, Page 10.

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