Reasonable people can disagree about whether pursuing health care reform was a mistake and how much opposition to the Affordable Care Act, as opposed to the state of the economy, is responsible for Democratic political troubles. But I think most of us would agree that the Democrats have done a horrible job of promoting it and, for that matter, the rest of the agenda. Joe Klein makes this point particularly well today:

There is a fundamental disconnect here: the Democrats passed legislation willy-nilly without giving the slightest thought, it seems, to how that legislation might be explained. This was especially true with the financial and health care reform packages. Why haven't the Democrats settled--as Republicans undoubtedly would have--on 3 top line talking points that would explain what financial regulation does? Health care reform was always going to be a heavy lift, since 80% of the American people are satisfied with the health care they have--but why should senior citizens know more about Medicare spending cuts in the bill (which will largely come out of a more efficient system, in which electronic record-keeping will reduce the need for duplicative procedures like, for example, blood tests) than they do about the $250 each of them has received to fill the prescription drug donut hole? As it has evolved this year, the public knows all the bad things about the bills that have passed--including more than a few "bad things" that aren't in them--but they haven't heard the plus side of the story. 
Tina Brown has a good column today about the President's need to be a more theatrical pol. We all know about the President's demeanor; it was the calm that got him elected after his opponent panicked in the midst of the financial crisis in 2008. But there is a need for him to be more blatant about his successes. I know it would probably bust the No Drama canon for Barack Obama to show up at some elderly person's door with one of the gigantic Publishers' Clearing House checks for $250--and some donuts--to announce the closing of the donut hole, but it would certainly lead the evening news (and the elderly are about the only people left who watch the evening news).

Of course, outside forces have also conspired to make health care unpopular. As Greg Sargent noted last week, opponents of the Affordable Care Act have, in just the last few months, spent more than $100 million on attack ads. That's an awful lot of money. I'm hard-pressed to think of another recent instance when advocacy groups spent so much, so quickly, to undermine legislation that had already passed. Given that many of these ads contain clear falsehoods, and given the law doesn't deliver most of its benefits until 2014, defending reform was always going to be difficult. But that's no excuse for the mediocre effort.