For the second time in a week, President Trump met Tuesday with "Obamacare victims" to highlight the plights of those whose healthcare arrangements were worsened by the law Republicans have long vowed to repeal and replace.
It's an example of Trump trying to take a leadership role on Obamacare as the rest of the Republican legislative agenda stalls despite unified GOP control of the federal government. But the Russia probe, along with Trump's own unpredictability and low approval ratings, has complicated the president's use of the bully pulpit.
"Millions of American families — and I mean millions — continue to suffer from Obamacare while congressional Democrats obstruct our efforts to rescue them," Trump said in Wisconsin. "And I'll tell you, that's exactly what's happening. The Democrats have let you down big-league."
"No matter how good it is, we will get no obstructionist Democrat votes," Trump said of the Republican healthcare bill. "If it's the greatest healthcare plan ever devised, we will get zero votes by the obstructionists, the Democrats."
But the headlines were dominated by Attorney General Jeff Sessions' testimony to the Senate Intelligence Committee on Russia and the firing of former FBI Director James Comey. Moreover, there were later reports that Trump might not think congressional Republicans have yet to come up with "the greatest healthcare plan ever devised."
Trump exhorted Republicans to act on healthcare and other items in the legislative queue when he met for lunch at the White House with 13 GOP senators. But he was also quoted as saying the House-passed Obamacare replacement was "mean," too difficult to defend publicly and needed to become more generous.
"We aren't going to comment on rumors about private conversations that may or may not have happened," said a White House spokesperson. The president did, however, campaign on passing a new healthcare law that was competitive with Obamacare in terms of the number of people covered, and he tweeted last month about the need to "add more dollars to Healthcare and make it the best anywhere."
"The president's vision for healthcare is really pretty straightforward," Vice President Mike Pence said earlier Tuesday. "We want a dynamic national, health insurance marketplace that lowers costs, increases quality and gives more choices to working families."
Getting a bill along these lines passed with no Democratic support and a small, divided Republican Senate majority has been no easy task. Trump celebrated with House Republicans in the Rose Garden when the American Health Care Act squeaked through that chamber despite a 24-seat GOP majority.
Trump is trying to go on the offense, pointing to rising health insurance premiums and insurers exiting the Obamacare exchanges as the enrollee population hasn't been young and healthy enough. He is also hoping Senate Republicans help him play defense, amending the healthcare bill to neutralize some of the top Democratic talking points against it.
"The president has been meeting with victims of all failed liberal policies," said Katrina Pierson, a former spokesperson for Trump's presidential campaign who is now with America First Policies, a pro-Trump group. "From Obamacare to illegal immigration and burdensome regulations, the president continues to stay plugged into the reason that he ran for office, to serve the people."
While supporters of immigration leniency have long publicized examples of undocumented high school valedictorians and entrepreneurs, Trump pushed back by showcasing the victims of crimes —including murder — committed by illegal immigrants. As president, Trump even launched a Victims of Immigration Crime Engagement Office inside the Department of Homeland Security.
Similarly, former President Barack Obama used public appearances and photo-ops with the uninsured and people with pre-existing medical conditions who might have benefited from Obamacare to help generate support for passing the law. Trump has recently struck back by telling the stories of those who say Obamacare has made them worse off.
A Capitol Hill Republican insider told the Washington Examiner that presidential leadership would be required to get sweeping reforms of the healthcare system and the tax code through the Senate, arguing Senate Majority Leader Mitch McConnell, R-Ky., couldn't do it all by himself.
Consequently, some Republican lawmakers welcomed Trump's engagement. "It's encouraging to see that this administration is taking a proactive approach to understanding and overcoming the obstacles Americans are facing under Obamacare," said Rep. Jack Bergman, R-Mich. "This is about more than numbers and anecdotes; it's about real people with real problems who have been priced out of the insurance market because of the [Affordable Care Act's] failures."
"These are conversations that are long overdue, and I believe they'll help us give the American people what they were promised years ago: access to quality, affordable healthcare," he added.
If Trump does want to substantially add to the healthcare bill's price tag at this point — or perhaps even if the perception exists that he does — it could add new hurdles. The legislation passed the House only with the overwhelming support of the conservative Freedom Caucus, and the administration has up to this point mostly negotiated with Republicans trying pull it to the right.
A similar problem would exist if there was any backsliding on the concessions that got so many House conservatives to vote yes: allowing states to apply for waivers from Obamacare mandates. But the belief that the bill won't make health insurance affordable enough for older consumers with pre-existing conditions is one of the main drivers of its unpopularity.
There is also the question of how effectively Trump can lead on healthcare while distracted by the Russia investigation and plagued by bad poll numbers. Trump's disapproval rating hit a high of 60 percent in Gallup's daily tracking poll Tuesday.
Yet the White House has good reason to press forward, as next year's midterm elections beckon and the window for passing a healthcare bill through reconciliation — and therefore without Democratic votes in the Senate — tightens.
"Republicans have had a lot of political and electoral success off the disaster that is Obamacare, so any day that the discussion is about Obamacare instead of Russia is a good day for the GOP," said Christian Ferry, a Republican strategist who managed Sen. Lindsey Graham's presidential campaign. "I think that discussion has a lot more relevance outside Washington and New York than the media would like to think."