President’s arms-length approach. President Obama decided early on to let Congress hash out the details of healthcare, which led to intra-party spats.
Failure to meet deadlines. Democrats couldn’t keep to their own deadlines, creating a sense of inaction despite the enormous progress made on the bills.
No strong message. Democrats never united behind a single message to the public, alternately portraying reforms as a deficit reducer, a consumer-protection bill, a moral imperative and even a jobs bill.
United Republican opposition. The GOP stood firm against the reforms with near-absolute unanimity, giving Democrats no choice but to assemble a fragile coalition.
Bad economy. Voters questioned why Congress was spending so much time on healthcare instead of jobs.
Climate change bill. Democrats decided to push a climate change bill through the House before healthcare, against the advice of centrists.
Too much negotiating. Democrats spent three months holding meetings to forge a grand bipartisan compromise on healthcare, even after some Democrats concluded the GOP had no interest in playing along.
Proposed “public option.” Democrats never came up with a version of a public health plan that satisfied enough centrists.
Unpalatable political deals. The public disliked Democratic leaders’ deals with centrists like Sen. Ben Nelson (D-Neb.) and Sen. Mary Landrieu (D-La.) to provide more Medicaid funding for their states.
Tax on “Cadillac” plans. A main reason why the House rejected fast-tracking the Senate reform bill was its inclusion of an excise tax on high-cost insurance plans.
Read The Hill’s report on health reform.