But the Social Security Act of 1935 was supported by a strong majority of Republicans in the House and Senate. The final votes on Medicare in 1965 were closer, but that program still won the support of a narrow majority of House Republicans and almost half the GOP senators.
In contrast, Obama's health reform had no Republican vote in either chamber.
This reform is especially vulnerable because the public does not see it as a broad middle class entitlement and because its most generous subsidies won't kick in until 2014. The benefit backloading was one factor that helped undermine public support for Medicare Catastrophic Coverage Act.
In addition, as Henry J. Aaron and Robert D. Reischauer point out, the federal government is relying on state authorities (some of whom oppose the reform) to play a big role in the law's implementation. If the Republicans win the White House or Congress in 2012, look for the law's taxes and mandates to be significantly modified.
Supporters of health reform need to put the cork back in the champagne bottle and get back to work.
In the next few years, they must find ways to make the law more acceptable to a skeptical public, more workable and, most of all, more fiscally sustainable.
If they don't, their hard-won political victory could remain at risk.
