Last week, Senate Democrats voted yes on health care because they had no choice. They confronted the same irrefutable fact that House Democrats had faced in early November when they passed their own bill by an eyelash. Once Obama started down this road, there was no turning back. If Democrats had blocked this measure, they would have branded their president as ineffectual and their party as incompetent.
Tough bargaining lies ahead, as House and Senate negotiators try to reconcile their two bills. But the same basic dynamic is likely to hold. Winning is better than losing. The president will probably sign a compromise measure and proclaim victory.
But that victory could cause the Democrats a huge political headache. On the eve of the Senate vote, the ABC/Washington Post poll reported that only 44 percent favored changing the healthcare system and 51 percent opposed.
More dangerous for the president, the public has soured on his handling of the issue. Last April, 57 percent approved of his performance, and 29 percent disapproved; today, 53 percent are negative and 44 percent positive. That's a swing of 37 points in just eight months.
Those numbers have Republicans salivating. By presenting a united front against health care, they are well placed to run hard on the issue and Sen. John Cornyn, a Texas Republican, is right when he said: "There will be a day of accounting. Perhaps the first day of accounting will be Election Day, 2010."
Why has the political prognosis swung so sharply against the Democrats? And do they have any hope for a recovery?
After all, these bills would do many good things. Thirty million more Americans would be eligible for health coverage. Insurance companies would be barred from denying or dumping sick clients. New technologies could start flushing waste out of the system.
The first answer lies in the numbers. Thirty million is a lot of people, but that amounts to only 11 percent of the population. When this debate started, 83 percent of Americans already had insurance, and most were happy with their coverage.
As a campaign slogan, change was an enormous asset. But as a guide for governing, that same idea became a threat, not a promise, for a lot of voters.
Obama has tried repeatedly to explain his point: If the system is not revised, premiums will go up, real wages will go down, folks could lose their policies if they get sick or change jobs. Those are good arguments, but they're too abstract -- and they haven't worked. Voters fear their costs will rise while their care declines.
Moreover, the larger political context is undermining Obama's persuasiveness. For one thing, Americans don't trust Washington. The Republican drumfire that these bills amount to a "government takeover" of health care distorts the facts, but works politically. In a recent Pew poll, "too much government involvement in health care" was the No. 1 reason cited by opponents.
A second issue is the budget deficit, which hit $1.4 trillion last year. When Democrats insist their bills are "paid for," many voters simply don't believe them and with good reason. The numbers might add up on paper, but Congress has repeatedly shown it won't make the unpopular choices necessary to finance a measure that could cost $1 trillion.
A third problem for the Democrats is the economy. Ten percent are out of work, and in the Pew poll, nine of 10 called the economy "fair" or "poor." That leaves little room for generosity. If the bill is "paid for," that money has to come from somewhere. Taxpayers know that and don't like it.
Fourth, the Democrats made matters worse, not better. Instead of promoting their cause to the public, they spent much of their time squabbling with one another. Liberal hardliners led by former party chairman Howard Dean squealed about surrendering to moderate heretics. And those moderates, especially Sen. Ben Nelson, went too far in squeezing out concessions.
When party leaders caved in and exempted Nelson's home state of Nebraska from increased Medicaid payments, they aggravated public cynicism and handed the Republicans a potent political weapon.
So Happy New Year, Mr. President! You won the battle, but it will take every last ounce of your persuasive powers to win the war.
Steve Roberts' new book,
"From Every End of This Earth" (HarperCollins), was published this fall. Steve and Cokie Roberts can
be contacted by e-mail at