President Trump threw his weight Monday behind a measure to fix parts of Obamacare, the first time he has voiced approval of a specific legislative approach to do so and an abrupt turnaround on a bipartisan effort to preserve key elements of the healthcare system that he has sought to repeal.
Trump's backing of what he repeatedly referred to as a "short-term fix" to ensure "good healthcare" came during freewheeling remarks in which he sought to mend relations with GOP leaders, even as he kicks a growing list of complicated issues to Congress, including immigration and the Iran nuclear deal.
Appearing with Senate Majority Leader Mitch McConnell after a White House lunch, Trump pledged to try to at least partially rein in his former strategist Stephen K. Bannon, who has vowed to challenge incumbent Republicans in 2018, especially those who back McConnell as leader.
He said "no, not at all" when asked whether he was considering firing Robert S. Mueller III, the special counsel investigating Russian interference in last year's election.
And he lauded Republican successes in confirming judicial nominees and promised swift approval of tax reform.
"We are probably now, I think — at least as far as I'm concerned — closer than ever before," Trump said, using the pomp of the Rose Garden for a news conference to signal a truce with the majority leader. "The relationship is very good."
The tone contrasted sharply with the barbs Trump repeatedly has tossed toward McConnell. In August, Trump left the door open to replacing the Kentucky senator as majority leader — responding equivocally to a question about whether he should step down — a drastic step for a sitting president.
Just hours before the lunch, in an earlier set of remarks, Trump repeated his unhappiness with the way his agenda has stalled in Congress, as well as his desire to place blame elsewhere.
"We're not getting the job done," Trump said. "And I'm not going to blame myself, I'll be honest. They are not getting the job done."
But it was Trump's comments on healthcare that could be the most immediately consequential.
For most of his presidency, Trump has insisted that the Affordable Care Act could not be fixed. When he has talked about working with Democrats on the issue, he has often couched that as a threat to Republicans.
Monday's remarks, after a weekend phone call with Sen. Lamar Alexander (R-Tenn.), the Health Committee chairman, who has been negotiating for weeks on a bipartisan healthcare measure, headed in a strikingly different direction, although Trump also repeatedly insisted that Obamacare was a failure.
"Obamacare is finished. It's dead. It's gone. You shouldn't even mention it. It's gone. There is no such thing as Obamacare anymore," he said earlier in the day.
Trump's comments came just days after he announced he would cut off payments to insurers that reimburse them for providing health plans with low deductibles and co-pays to low-income consumers. Alexander's approach, which Trump appeared to endorse, would reinstate those payments in return for some Republican priorities, including more flexibility for states in overseeing their healthcare systems.
State insurance regulators, patient advocates and insurers have warned that premiums would rise sharply if the government ends the payments. The impact would be most severe in Republican-controlled states, according to independent analysts. Ending the payments would also increase federal spending because as premiums rise, so does the assistance the government provides people to make them affordable.
Trump boasted that his decision to cut off the insurance subsidies, known as cost-sharing reduction payments, had pushed Democrats to the negotiating table on the Affordable Care Act.
"Because of that, people are talking now," Trump said. "Democrats are talking to the Republicans."
In fact, bipartisan healthcare discussions have been underway in the Senate for months. They were derailed in September when Senate GOP leaders abruptly abandoned talks and revived their push to repeal the healthcare law. With the defeat of that latest Obamacare repeal effort, Alexander and Sen. Patty Murray (D-Wash.), the top Democrat on the health panel, restarted talks.
Trump and Alexander spoke by phone over the weekend, and "the president encouraged him to get a bipartisan deal," according to an aide to the senator who said the two also spoke the previous weekend.
Congressional aides said Monday they were nearing a compromise. "Good progress was made over the last week," said a Republican staff member.
The deal being worked on is expected to continue the cost-sharing reduction payments for at least another year, possibly two. Many state regulators, insurers and consumer advocates say doing so is crucial to controlling premiums and stabilizing markets.
In exchange, Republicans are seeking changes in the current law that would make it easier for states to dispense with some federal insurance regulations. Alexander has emphasized that he doesn't want to roll back protections for Americans with preexisting conditions.
"I'm hopeful that we are nearing an agreement," said Senate Democratic leader Charles E. Schumer of New York. "If he's now supportive of an agreement that stabilizes and improves the existing system under the Affordable Care Act, we certainly welcome that change of heart."
The details remain in flux, however, and some Republicans want a bigger rollback of federal regulations so states can offer plans that provide less coverage but come with a lower price tag.
"I think we're encouraged that there are people talking, but I think that we do have a policy difference," said Marc Short, the White House's director of legislative affairs. "That starting point doesn't seem like it's a realistic one for us," he added, referring to Alexander's proposals so far.
The Rose Garden event came at a time when congressional Republicans are desperate to show voters they can deliver for the president, who remains highly popular among GOP primary voters.
Trump welcomed McConnell as "a friend of mine for a long time," despite having repeatedly blamed and scolded the Kentucky Republican for Congress' failure to repeal Obamacare.
"We have been working together long and hard," Trump said.
The more buttoned-down McConnell, who has made no secret of his own objections to Trump's often-disruptive style, agreed they were moving forward on tax cuts, judicial nominees and other issues.
"We have the same agenda," McConnell said.
Even so, there were differences.
When Trump said he thought there was a good chance of "getting the taxes done, hopefully fairly long before the end of the year," McConnell quickly interjected with a reminder that the congressional process is seldom that fast.
"Obama signed Obamacare in March of year two. Obama signed Dodd-Frank in July of year two," he said.
Crucially for McConnell, however, Trump said he would try to talk Bannon into relenting — at least in part — in his self-proclaimed "war" on Republican incumbents.
Earlier in the day, Trump said that he could "understand where Steve Bannon is coming from," but with McConnell standing next to him, he took a more conciliatory tone.
"Steve is doing what Steve thinks is the right thing. Some of the people that he may be looking at, I'm going to see if we can talk him out of that, because, frankly, they're great people," he said, adding a moment later, "with the exception of a few."
Times staff writers Noam N. Levey and Brian Bennett in Washington contributed to this report.