Though conservatives and Republicans have been very vocal in the health reform debate, it is congressional Democrats who will determine whether or not the bill passes. Jay Cost has done an excellent job of keeping tabs on the House Democrats at the center of the drama. Already the White House seems to be inching away its notional deadline, and efforts to draw on and build outrage over premium hikes represent a new, more concerted strategy to change the political dynamic.

A Kaiser poll conducted in late 2008 found that roughly 25 to 30 percent of Americans worry about losing their health insurance or their job, numbers that may well have increased during the downturn. But in politics, the salient question is how these voters are distributed across political space, i.e., how many are in swing districts, how many are swing voters, etc. Tax cuts have tended to be a low priority for the electorate overall, yet some tax cut proposals, like efforts to curb or eliminate the estate tax, resonate with tax-sensitive voters in competitive regions.