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His average approval rating had sunk below his disapproval rating for the first time in his presidency but yesterday's passage of his historic, much-amended and pork-filled healthcare bill gives President Obama his most significant accomplishment since entering office – an accomplishment that eluded many of his Democrat predecessors, notably Bill Clinton.

Republicans console themselves with the likelihood of significant gains in November's mid-term elections. Early polls suggest seven Senate pick ups. David Frum counsels them against expecting big gains. The economy will be improving by then, he warns, and some of the "goodies" in the healthcare bill will be reaching key constituencies by then. But even if Republicans make gains, Frum is still despondent:

"Legislative majorities come and go. This healthcare bill is forever. A win in November is very poor compensation for this debacle now… This bill will not be repealed. Even if Republicans scored a 1994 style landslide in November, how many votes could we muster to re-open the “doughnut hole” and charge seniors more for prescription drugs? How many votes to re-allow insurers to rescind policies when they discover a pre-existing condition? How many votes to banish 25 year olds from their parents’ insurance coverage? And even if the votes were there – would President Obama sign such a repeal?"

At The Weekly Standard Bill Kristol disagrees, arguing that mitigation of the legislation is still possible.

For Andrew Sullivan the political victory for Obama is that he has shown that he is more than a great speechmaker and sloganiser. He is, says Sullivan, a president of persistence:

"Imagine the narrative shift if this bill is passed. Obama will not have imposed this monstrosity on the country from on high; he will have ground it through the bloggers, and the pundits will declare a resurrection. The narrative will be about his persistence and his grit, rather than his near-divinity and his authority. And suddenly it will appear — lo! — as if this lone figure has not just rescued the US economy from the abyss, but also passed the biggest piece of social legislation in decades. There is only one story better than Icarus falling to earth; and it’s Icarus getting back up and putting on some shades. The media will fall for it. The public will merely notice that the guy can come back and fight. Even when they don’t always agree with such a figure on the issues, they can admire him."

For doom and gloom Mark Steyn at the National Review is unbeatable. He sees Obama's victory as a big step towards the Europeanisation of America:

"If Barack Obama does nothing else in his term in office, this will make him one of the most consequential presidents in history. It's a huge transformative event in Americans' view of themselves and of the role of government. You can say, oh, well, the polls show most people opposed to it, but, if that mattered, the Dems wouldn't be doing what they're doing. Their bet is that it can't be undone, and that over time, as I've been saying for years now, governmentalized health care not only changes the relationship of the citizen to the state but the very character of the people. As I wrote in NR recently, there's plenty of evidence to support that from Britain, Canada, and elsewhere. More prosaically, it's also unaffordable. That's why one of the first things that middle-rank powers abandon once they go down this road is a global military capability. If you take the view that the U.S. is an imperialist aggressor, congratulations: You can cease worrying. But, if you think that America has been the ultimate guarantor of the post-war global order, it's less cheery. Five years from now, just as in Canada and Europe two generations ago, we'll be getting used to announcements of defense cuts to prop up the unsustainable costs of big government at home."

> WATCH: President Obama welcomes the passing of his healthcare bill

89 comments for: The Republicans may make short-term gains on the back of ‘ObamaCare’ but America has taken significant leftwards turn

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