The president called Alexander again on Wednesday morning to offer encouragement, the Tennesseean said at an event hosted by Axios. But Trump’s subsequent tweet could scuttle the deal altogether, providing cover to conservatives who are already denouncing it as a cave to Democrats and a retreat from the Republicans’ longstanding, if unrealized, commitment to repealing and replacing Obamacare entirely.

As if on cue, a spokesman for House Speaker Paul Ryan signaled opposition to the agreement after withholding judgment a day before. “The speaker does not see anything that changes his view that the Senate should keep its focus on repeal and replace of Obamacare,” Ryan spokesman Doug Andres said. In his own series of tweets, Alexander tried to offer a path forward, saying that while his legislation had “strong language” to guarantee insurers wouldn’t simply pocket the payments from the government, he would work with Trump to make it even tighter.

Trump’s flip-flop may be jarring to Alexander, but it’s not surprising. For a president who campaigned as a decisive deal-maker, inconsistency has been a hallmark of his first year in office. Back in July, my colleague David Graham catalogued his ever-changing positions on health care.

But Trump’s handling of this latest episode closely tracks his more-recent moves on immigration. In September, the administration announced an end to the Deferred Action for Childhood Arrivals program, raising the specter that millions of young people brought illegally to the U.S. as children could be at risk for deportation. As on the insurer payments, Trump couched his decision in legal terms, arguing that the administration could not act without the approval of Congress. Then, he surprised both his party and the public by floating the outlines of a deal with Democrats in which he would agree to protect DACA recipients in exchange for additional border security measures.

Yet that position, too, did not last long. After blowback from conservatives, Trump issued hardline demands that departed wildly from what he told Democrats he could accept. More than a month after Trump’s first optimistic meeting with Democrats on immigration, the DACA deal has gone nowhere.

The flirtation with bipartisanship on health care could follow the same murky path. Once again, Trump revoked a policy and is forcing Congress to restore it. But his own inconsistency seems to be standing in the way. Lawmakers on Capitol Hill often issue vague demands for “presidential leadership” when they don’t want to take responsibility for a problem or make a decision themselves. In this case, however, Trump’s opinion matters to Republicans. They need to know, first of all, whether he would sign legislation if they pass it, and second, whether he will help defend the law to conservative voters who may recoil at a measure propping up Obamacare. “You cannot govern a country if you do not know what a bill does and keep a consistent policy about it,” Senate Minority Leader Charles Schumer said on Wednesday.