President Trump speaks during an event about prescription drug prices in the Rose Garden of the White House on May 11. (Evan Vucci/AP)

President Trump’s announcement that he would not force drug companies to lower prices for older Americans marked at least the fourth populist economic promise he has abandoned since taking office.

Instead, his changes have frequently pivoted toward policies pursued by big companies and the wealthiest Americans, even though he vowed trouble for both during the 2016 campaign.

On Jan. 26, 2016, he promised to use Medicare’s economic leverage to negotiate lower drug prices in a way he said would save the government $300  billion a year. The Obama administration, he told a New Hampshire crowd, could have pursued such an effort but didn’t “do it. . . . Why? Because of the drug companies.”

But Trump announced in a Friday speech that he wouldn’t take this step, instead opting for incremental changes to Medicare that could lower prices for some seniors. Drug company stocks rallied after the address, as it became clear that no serious crackdown was underway.

It marked a similar pattern. He had promised to get tough with Wall Street, raise taxes on hedge fund managers and push for a $1 trillion infrastructure package that would create millions of jobs. He has done none of those things.

Instead, he has taken steps to deregulate Wall Street, cut taxes for hedge fund managers and shelved his plan for infrastructure jobs.

A White House spokeswoman declined to comment.

Some conservatives view the retreat as a policy move away from ideas that were impractical.

“There is this problem that a lot of the things that were effective sound bytes just aren’t good policy,” said Douglas Holtz-Eakin, a Republican and former Congressional Budget Office director who has long warned that the Medicare drug price idea would never work.

Others in Trump’s orbit concede that there is a gap between Trump’s promises as a candidate and his follow-through as president.

“Sometimes campaign bark is worse than the bite in the White House,” said a senior administration official who spoke on the condition of anonymity to discuss the administration’s record candidly.

Democrats have continually accused Trump of abandoning the populist promises he made to working-class and middle-class Americans during the campaign, saying his decision to surround himself with economic advisers from Wall Street marked a betrayal of the voters to swept him into the White House.

“There’s an irony,” Rep. Peter Welch (D-Vt.) said Friday in an interview. “Donald Trump got elected by rural America, and he demonstrated in the campaign a connection to the concerns they have about how they’re getting ripped off. As president, he’s sided with the rip-off artists instead of the rural folks who voted for him.”

Welch and Rep. Elijah E. Cummings (D-Md.) met with Trump in 2017 to talk about the drug pricing issue and they introduced a bill that would allow Medicare to negotiate drug prices. They said after the meeting that Trump told them he embraced their idea, but that it went nowhere in part because of fierce lobbying from the pharmaceutical industry.

Trump also promised to hammer Wall Street during the 2016 campaign. With Trump’s backing, the Republican National Convention that year adopted as one of its principles the idea of reimposing Depression-era rules known as “Glass-Steagall” that would splinter commercial and investment banks. Instead, Trump and his advisers have worked since last year to deregulate the banking industry, and Congress is on the cusp of passing a bill that would roll back some of the financial regulations put in place after the 2008 economic crisis.

Although opposed by progressive Democrats, the legislation has bipartisan support — as well as White House backing — and would exempt about two dozen financial companies from some of the toughest banking regulations. The bill also would scale back scrutiny of smaller banks from certain mortgage rules, among other provisions.

On taxes, Trump and Treasury Secretary Steven Mnuchin had promised that there would not be a net tax cut for the wealthiest Americans. And Trump specifically vowed to raise taxes on hedge fund managers, who he said benefited from a loophole often referred to as “carried interest.”

“One thing I’d do is get rid of carried interest, one of the greatest provisions for people like me,” Trump said during a presidential debate in 2016.

But the tax law Republicans pushed last year did not eliminate this loophole for hedge fund managers. Then-White House National Economic Council (NEC) director Gary Cohn said in December that the White House tried repeatedly to eliminate this tax break during negotiations with lawmakers but repeatedly failed.

“We probably tried 25 times,” he told Axios last year.

Trump’s biggest economic achievements have been his massive tax cut law and the wave of deregulation he has pushed through multiple agencies, particularly focused on environmental policy and consumer protection. The tax law will give almost all taxpayers a cut, but independent projections say the savings will be heavily concentrated among corporations and the wealthy.

U.S. Trade Representative Robert E. Lighthizer and Commerce Secretary Wilbur Ross are negotiating separate trade agreements with a handful of countries that would also follow through on other campaign promises Trump offered voters, changes he has said would lead to more manufacturing jobs in the United States.

But the status of those negotiations is uncertain.

The White House has effectively delayed another of Trump’s biggest campaign promises, the creation of $1 trillion in new spending on infrastructure projects that would rebuild roads, U.S. ports, schools, housing and airports.

White House officials were often at odds over how to pay for the idea, and Democrats grew suspicious when it became clear that the Trump administration wanted to rely on outside financing, including via tolls and privatization. The top infrastructure official at the NEC resigned several months ago and was never replaced.

“I don’t think you’re going to get Democrat support very much” on infrastructure, Trump said in March. “And you’ll probably have to wait until after the election, which isn’t so long down the road.”

It’s unclear what all this means for Trump and Republicans heading into the November midterm elections.

Liberals and Democrats are trying to make Trump’s decision to back away from some of these populist ideas into campaign issues.

“The president made clear today that he will not keep the promises he made during the campaign to lower the outrageously high cost of prescription drugs,” Sen. Bernie Sanders (I-Vt.) tweeted Friday. “Instead, he has become a supporter of the pharmaceutical industry’s extraordinary greed.”

But polling suggests that Trump’s popularity has improved in recent weeks, and on Thursday he packed a middle school gymnasium in Indiana, where he was talking about his record.

“The economy is just so strong, especially in a lot of these Midwestern states now,” said Steve Moore, who was an economic adviser to Trump during the campaign and is co-writing a book called “Trumponomics.”

“If you look at the polling, voters are ecstatic,” he said.

Moore said that although Trump hasn’t yet followed through on some of these promises, he could still do it soon. He said, for example, that Trump had a number of other pledges that he was fighting to enact, such as building a wall along the Mexico border.

“Here’s one thing I’ll say about Trump: He doesn’t give up,” Moore said.