Since Obama began pushing his plan - aimed at insuring more Americans while slashing health-care costs - last spring, there's been something for everyone to complain about. Conservatives see health-care reform as an overreaching power grab by Washington, liberals worry that Democrats are too cozy with insurance-industry lobbyists and Beltway pundits fret that Obama may lack what George H.W. Bush famously called "the vision thing."
"For his agenda, this is huge," said G. Terry Madonna, the political scientist and pollster from Franklin and Marshall College. "The president has decided that national health-care reform is his No. 1 priority."
What will the president say tonight, and where will it all end up for Obama and the nation? The Daily News tries to break it all down.
Q. Obama is only one-sixth of the way through his term in office, so why are people looking at his health-care push as his defining moment?
A. Few recent presidents have promised to change the direction of the nation and the way that Washington does business as much as Obama did during his campaign, and he energized many once-apathetic voters in the process.
Now, these voters want Obama to deliver - especially after also giving the Democrats a huge majority in the House of Representatives and bringing them to the cusp of the 60 votes needed to get key bills out of the Senate.
As for the timing, history has shown that presidents - even those serving a full eight years - often set the tone in Year One. In addition to Bush 43 and the response to 9/11, Ronald Reagan cut taxes after seven months in office while Bill Clinton's spending plan that ultimately balanced the budget (briefly) also came in August of his first year. On the other hand, Gerald Ford pardoned Richard Nixon after a month in office - and never recovered.
Q. I've read a lot about Obama's popularity plunging as the health-care debate drags on. Is that right?
A. Certainly the president's approval rating has dropped sharply since he registered a healthy 69 percent in the initial Gallup Poll back in January, to just 50 percent in its most recent survey. Most experts blame a combination of factors, including voter frustration over unemployment, at its highest level in 26 years, as well as conservatives and moderates who think that Washington is doing too much and liberals who say it's not doing enough.
Q. Has the health-care debate been a part of Obama's fall?
A. Pollster Madonna believes that it is - noting that he's seen Obama's support among moderate, independent voters fall about 15 percentage points in recent weeks and that he believes that that is because Democratic reform plans are more ambitious and more expensive than they would like. Said Madonna: "He allowed Congress to write a bill that's way too complex and too overreaching."
Q. So why did Obama let Congress take the lead role in drafting the plan until now?
A. Most experts think that the Obama administration - like the generals who are always fighting the last war - want to do the opposite of how Clinton handled health care in 1994, when an ambitious plan failed in part because key lawmakers had no involvement in drafting it.
Larry Sabato, the University of Virginia history professor and political pundit, said that he thinks that Congress is also more motivated than 1994 because Democrats are more liberal than 15 years ago - when the party still had a large contingent from the Deep South - and because they realize that they could suffer heavy losses in 2010 if health care fails completely.
Q. So what does Obama do in his speech tonight?
A. Many experts think that Obama is searching for the magic compromise that will keep a handful of conservative Democrats like Nebraska Sen. Ben Nelson on the reservation, attract centrist Republican Olympia Snowe, of Maine, and not move so far rightward to inflame liberal Democrats.
The idea getting the most attention: A bill that aims to keep health insurance in the hands of private companies but with a so-called "trigger" that would create a government insurance plan - the so-called "public option" - in the future if too many Americans are still uninsured and other targets go unmet.
Another wild card is a compromise plan in the Senate worked up by key centrist Max Baucus, of Montana. It was still largely under wraps last night. One reported aspect of the Baucus plan - requiring all Americans to purchase health insurance with fines for those who do not - could prove highly controversial.
Q. Has Obama given up on pushing for the public option right now?
A. Hard to say. As a candidate, he supported this idea - in theory, a government health-insurance plan would have lower costs and thus force private insurers to compete - but his aides have now given mixed signals amid predictions that the public option could not get 60 votes in the Senate.
A senior administration official told McClatchy Newspapers last night that Obama will tell the nation that he sees the public option as "the best mechanism, but not the only mechanism."