Observers on both sides of the political aisle have noted, often with surprise, President Obama’s failure to offer an agenda for a second term in office. It would be a mistake, however, to assume Obama has no second-term agenda; he simply doesn’t have one he can express aloud. In truth, the president’s main agenda item for a second term is to cement the result of his first term that Americans like least—Obama-care. It is fitting, then, that the principal reason why Obama seeks reelection may prove to be the primary cause of his defeat.

If Obama loses his bid for reelection, it won’t be because the economy hasn’t turned around, or because his tone of incivility has started to grate on voters, or even because he apparently didn’t bother to prepare for the first presidential debate and ran up against an opponent who did (although each of these things will have played a key role). It will be because of Obama-care.

The week before Obama gave his June 2009 speech to the American Medical Association—the unofficial kickoff of the health care debate—Gallup’s polling showed that the American people overwhelmingly approved of the way he was handling his job as president. His net approval rating was plus-30 points (61 percent approving, 31 percent disapproving). In addition, the president enjoyed an overwhelmingly Democratic House, a filibuster-proof Democratic Senate, and the true believer’s conviction that spearheading government-run health care would secure his place “on the right side of history.”

Nine months later, as he signed Obama-care into law, Obama’s net approval rating had plummeted 25 points, to plus-5 points (49 percent approving, 44 percent disapproving) in Gallup’s weekly polling of all adults, meaning he was probably underwater with likely voters. It has never recovered. More than two-and-a-half years later, Obama’s net approval rating in Gallup’s most recent weekly polling is right where it was when he put his pen to Obama-care—at plus-5 points among all adults (50 percent approving, 45 percent disapproving).

There are several reasons why Obama’s popularity fell dramatically during the health care debate and never rebounded. For starters, his emphasis on Obama-care was the first indication of something that’s become increasingly obvious to voters over time: Obama doesn’t really care about the economy. For nine months, while the American people wanted him to focus on the economy, Obama wanted to focus on putting the nation’s health care system under the yoke of the federal government. So that’s what he did.

In spearheading Obama-care’s passage, moreover, the president didn’t just neglect the economy; he made it worse. The looming specter of Obama-care provides powerful incentives for businesses not to hire new workers. And once the law fully takes effect (unless it’s repealed first), Obama-care will provide similarly strong incentives for businesses not to employ workers for as many as 30 hours a week—the point at which any employer of 50 or more workers will be compelled to provide federally approved health insurance. As a result, the 29-hour workweek—and corresponding pay—will become commonplace.

Nor has Obama’s interest in the economy increased noticeably over time. During the presidential debates, he didn’t even convincingly feign interest in promoting economic growth to spur job creation. The two job-creation proposals that he most frequently espoused during the debates were his desire to hire more teachers at taxpayer expense and to “invest” more taxpayer money in “green energy” jobs. But the former seems to relate more to his concern for education (at best) or his desire to provide payback to a supportive union (at worst) than to a desire to fuel the economy as a whole, while the latter seems to excite Obama not because it would create jobs, but because it would allow Obama to funnel more people into activities of which he approves. As for a plan actually designed to increase economic growth, he’s had next to nothing to say.

The process by which Obama-care was passed also exposed the president’s odes to bipartisanship as empty and disingenuous. In truth, it’s hard to imagine a process more partisan than the ugly one by which Obama-care was forced on the opposition party and an unwilling citizenry. It included colorfully named backroom deals to secure key votes (the Cornhusker Kickback, the Louisiana Purchase, Gator Aid). It involved a Grinch-like Christmas Eve vote in the Senate. Then, after even the voters of Massachusetts had seen enough and sent Republican Scott Brown to fill the Senate seat vacated by the death of Ted Kennedy, it involved circumventing the normal legislative process and passing Obama-care through “reconciliation”—a process intended to facilitate deficit reduction, not to launch a massive new entitlement. In the end, not a single Republican in either chamber of Congress voted for the overhaul. The whole sordid process was to bipartisanship as the 1962 Mets were to baseball greatness.

Obamacare has hurt the president’s popularity in another crucial way. Contrary to what Obama may have thought, Americans didn’t elect him for the job of “fundamentally transforming the United States of America”—as, in a moment of candor five days before the 2008 election, he pledged to do. It was during the health care debate that Americans got their first glimpse of what Obama had in mind when he uttered those words.

As the citizenry quickly recognized, Obama-care is no ordinary piece of legislation. It’s an unprecedented 2,700-page onslaught on limited government, liberty, and the ideals of the American Founding. If not repealed, it will mean having the federal government—for the first time in our nation’s history—compel private American citizens to buy a product or service of the federal government’s choosing, simply as a condition of living in the United States. It will mean living in a more litigious society, as bureaucrats continually add to the 13,000 pages of Obama-care regulations already written.

It will mean granting a frightening degree of unchecked, quasi-legislative power to the secretary of health and human services, who has already decreed—in flagrant disregard of religious liberty—that almost all Americans are hereby banned from buying health plans that don’t provide “free” coverage of birth-control pills, sterilization, and the abortion drug ella. It will mean granting similar quasi-legislative power to a 15-member Independent Payment Advisory Board of Obama-care’s creation, which will order Medicare cuts that—as the law stipulates—cannot be overruled even by the people’s representatives through the normal legislative process. It will mean empowering scores of other newly created bureaucratic boards, commissions, agencies, and the like, few if any of which will be directly accountable to the citizenry.

In short, it will mean consolidating and centralizing unconscionable sums of power and money in Washington, as the federal government effectively takes control of the nation’s health care system—nearly one-fifth of our entire economy.

Yet Obama-care isn’t designed to stop at “effectively” taking control. Obama has previously expressed his support for a government monopoly over health care (preferring to call it a “single-payer health care plan”). About a year before his breakout speech at the 2004 Democratic National Convention, Obama said, “I happen to be a proponent of a single-payer, universal health care plan. .  .  . That’s what I’d like to see. But .  .  . first we’ve got to take back the White House, we’ve got to take back the Senate, and we’ve got to take back the House.”

In the context of these remarks, it is perhaps easier to see why Obama was so determined to push Obama-care forward, to keep pushing after the public uprising during the 2009 August recess, and then to keep pushing even after the election of Scott Brown. Along the way, however, Obama was forced to relinquish the “public option,” the highly unpopular proposal to have government-provided insurance—subsidized through an almost bottomless supply of taxpayer funding—“compete” against a hamstrung private insurance industry on an uneven playing field. Eventually, the “public option” would be the only “option” left standing and—voilà!—single-payer health care would arrive on our shores.

The “public option” would have bred disastrous results. But without it, Obama-care isn’t even designed to succeed. This is of little concern to the president—for, once Obama-care has led to the collapse of the private insurance industry, the only option left will be a complete government takeover. It is, however, of grave concern to the American people. Describing Obama-care as passed, after the “public option” had been jettisoned, Yuval Levin put it this way in these pages:

The result is not even a liberal approach to escalating costs but a ticking time bomb: a scheme that will build up pressure in our private insurance system while offering no escape. Rather than reform a system that everyone agrees is unsustainable, it will subsidize that system and compel participation in it—requiring all Americans to pay ever-growing premiums to insurance companies while doing essentially nothing about the underlying causes of those rising costs. .  .  . Once implemented fully, it would fairly quickly force a crisis that would require another significant reform. Liberals would seek to use that crisis, or the prospect of it, to move the system toward the approach they wanted in the first place.

In short, Obama-care “is designed to push people into a system that will not exist—a health care bridge to nowhere.”

And that’s where Obama wants to lead us in a second term.

Jeffrey H. Anderson is a frequent contributor to The Weekly Standard.

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