If a president can't sell a program, is it his fault?
Barack Obama had an opportunity to shape public opinion on health care reform. When he started his push, the idea of reform was broadly popular. In April 2009, 59 percent of respondents in a Kaiser health care poll believed health care reform was more important than ever — even amid an economic downturn. Only 37 percent said we couldn't afford health reform because of economic problems. But the more Obama worked on the legislation, the more partisan the issue became. Soon the numbers began to turn against him. It became a game of beat the clock: Could he get the bill through Congress before opposition to it calcified? But Obama didn't sprint. He thought he could keep the public on board while everyone waited for the Senate Finance Committee and its chairman Max Baccus to deliver a bipartisan agreement. During that time, the president allowed the health care bill to take a pounding each day, lowering its popularity. In February 2009, the president's approval rating on the question of health care was a rosy 57 percent favorable to 41 percent unfavorable. By the time he signed the law in March 2010, those numbers had flipped. Even under a president with rhetorical gifts, the partisan and confusing nature of public-policy debates can overwhelm the oratory.
In the end, Obama had to jam the bill through. As health care reform came to a vote, Obama was no longer trying to win over Republicans or protect his brand. He supported the Senate use of reconciliation, a back-door procedural move that destroyed any chance of bringing along Republicans, and he turned his megaphone toward rallying his own troops. That's a place where presidential rhetoric can be powerful. Obama's speech to House Democrats on the eve of the vote appealed to the common bonds that brought them into politics as Democrats. Since then, public support for the legislation has not improved.