In a troubling sign for the president, who over the past several days has threatened to end "bailouts" for insurers and, according to Rand Paul, is contemplating executive action to pursue his quest of repealing Obamacare, some Senate Republicans are now openly defying Trump's directives.

As The Hill reports, Sen. Lamar Alexander (R-Tenn.), head of the Senate Health, Education, Labor and Pensions Committee, announced Tuesday that he will hold hearings and would work with his Democratic colleagues to “stabilize and strengthen” the individual insurance market under the Affordable Care Act, which the president has urged the Senate to keep trying to repeal. Alexander also urged the White House to keep up payments to insurers that help low-income consumers afford plans, which Trump has threatened to cut off.

The hearings will give Democrats, particularly Sen. Patty Murray (Wash.), the committee’s ranking member, a seat at the negotiating table on healthcare for the first time, opening up a process that until now had been tightly controlled by Senate Majority Leader Mitch McConnell, who however suffered a major loss last week when he failed to pass repeal following the holdout vote of John McCain.

Openly defying Trump, who suggested he’ll let ObamaCare implode, Alexander - in working with Democrats - is actively trying to prevent that from happening. “We need to put out the fire in these collapsing markets wherever these markets are,” Alexander said at the beginning of a Senate Health, Education, Labor and Pensions Committee hearing on nominations.

According to press reports, committee staff members are hitting the ground running, beginning to prepare for the hearings this week. The panel wants to hear testimony from insurance commissioners, patients, insurance companies, governors and healthcare experts. Time is of the essence for Alexander:

Insurers must sign contracts with the federal government at the end of September saying they’ll sell plans on the exchanges. They’ve been pleading with Congress and the administration for long-term certainty that they’ll continue to receive crucial payments compensating insurers for subsidizing out-of-pocket costs for certain consumers. But Trump has threatened to withhold those payments, which the administration has been making on a month-to-month basis. Kellyanne Conway, a White House adviser, said on “Fox News Sunday” that Trump would decide this week if he’ll cut off the payments.

Yet even as Alexander talks of stabilizing the markets, conservative lawmakers and groups remain opposed to aiding ObamaCare in any way. “The Senate’s inability to produce 51 votes for a piece of legislation that delivers on a seven-year campaign promise to repeal and replace Obamacare is not license for a bipartisan bailout of a failing law,” Michael A. Needham, CEO of Heritage Action, said in a written statement.

After the Senate’s failed vote, Sen. Ted Cruz (R-Texas) suggested the Republican effort isn’t yet over. “No party can remain in power by lying to the American people, and I hope and pray that our party doesn’t try to do that,” Cruz told reporters. And McConnell, who said it was “time to move on” after last week’s failed healthcare vote, on Tuesday left the door open to reviving the legislation. “We’re continuing to score some of the options on healthcare,” McConnell told reporters during a weekly press conference on Tuesday. “There’s still an opportunity to do that.”

Yet with the Senate set to leave town in mid-August, it appears unlikely that healthcare legislation will pass before September - if then - which could create an opening for Alexander to pursue a deal with Democrats.

Some Republicans in the House have already started working across the aisle. The bipartisan Problem Solvers Caucus, consisting of 43 Republicans and Democrats, on Monday unveiled proposals that they said would fix problems with the Affordable Care Act.

Rep. Charlie Dent (R-Pa.), a centrist who voted against the House GOP’s healthcare bill, said he’s already been talking to senators about the proposal. And Rep. Tom Reed (R-N.Y.), a leader of the caucus, said he’s “pleased to see Lamar Alexander taking the lead and beginning to hold hearings on what we’re discussing here.”

Meanwhile, as WaPo adds, "several Republican senators have sought to distance themselves from the president, who has belittled them as looking like “fools” and tried to strong-arm their agenda and browbeat them into changing a venerated rule to make it easier to ram through legislation along party lines.

Some are describing the dynamic in cold, transactional terms, speaking of Trump as more of a supporting actor than the marquee leader of the Republican Party. If he can help advance their plans, then great, they say. If not, so be it. “We work for the American people. We don’t work for the president,” Sen. Tim Scott (R-S.C.) said. He added, “We should do what’s good for the administration as long as that does not in any way, shape or form make it harder on the American people.”

While the fate of Obamacare remains unclear, the growing friction within the GOP underscores the challenge Republicans face headed into the fall. As they seek to move beyond a failed health-care effort in pursuit of an elusive, first big legislative win, the same infighting that has plagued them all year threatens to stall their push to rewrite the nation’s tax laws, which Senate Majority Leader Mitch McConnell (R-Ky.) said Tuesday he wants to do in September.

Yet while all these initiatives can be delayed indefinitely, one which can not is the debt ceiling, which looms large with the US expected to run out of cash in late September.

In a Monday note commenting on this growing threat, Compass Point analyst Isaac Boltansky said he is becoming increasingly concerned fall deadlines for federal government funding and the debt ceiling will prove tougher than the market currently expects "with markets roiled heading into 4Q and Fed’s policy normalization trajectory facing complications." He notes that the increasingly fragmented legislative landscape may be set to "transition from inaction to dysfunction", citing such factors as:

Lawmakers return in Sept. with no clear strategy

GOP leaders will likely be forced to rely on sizable contingents of Democrats

Current spending caps for FY2018 are "despised" by both Democrats, Republicans, but for wholly different reasons

White House’s position remains unclear as Treasury Sec. Steven Mnuchin has repeatedly called for a clean debt ceiling increase, but over the weekend President Donald Trump and OMB Director Mick Mulvaney suggested putting legislative activity on hold until health care is addressed

As a result, Boltansky sees odds of govt shutdown as materially higher than the likelihood of reaching debt ceiling as core components of spending fight (including border wall funding) are "meaningfully more politically complicated" than raising debt ceiling; his base case is for the federal government to face a brief shutdown in early October.

Whether this seemingly impregnable market will respond to an official government shutdown (with many speculating that the market is surging precisely because the US government is already deadlocked, if unofficially so far) in two months, remains to be seen.