Obama Feared a ‘One-Term Presidency’ After Passing Health Care Law

By the time his ambitious health care legislation was introduced and carved up and cursed and left for dead and revived and compromised and passed and finally signed into law, the whole process had taken a toll on President Barack Obama.

The passage of the Affordable Care Act would be his signature legislative achievement, but it propelled Republicans to a sweeping midterm election victory and control of the House. And Mr. Obama thought he might be the next to pay the price at the ballot box. “This is shaping up to be a one-term presidency,” he told an aide in late 2010.

He turned out to be wrong, but the fatalism Mr. Obama expressed privately that day captured the weighty consequences of one of Washington’s most high-wire legislative battles in modern times. A new set of oral histories released on Friday, on the eve of its 14th anniversary on Saturday, documents the behind-the-scenes struggle to transform the nation’s health care system to cover tens of millions of Americans without insurance.

The interviews of key players in the drama were conducted by Incite, a social science research institute at Columbia University, and were made public as the second tranche of a yearslong effort to document the eventful times under the nation’s 44th president. The transcripts posted online on Friday included recollections from 26 members of the White House staff, his cabinet and Congress as well as activists, interest group figures and a handful of Americans who made their voices heard, but not from the former president himself or, for that matter, his Republican opponents.

The oral histories chronicle Mr. Obama’s journey from an uninformed candidate embarrassed by the banalities he found himself spouting on the campaign trail to a besieged president gambling his political future on all-or-nothing legislative brinkmanship. They also flesh out a portrait of Mr. Obama as a steady-as-she-goes, hyper-disciplined but not especially warm, policy wonk who scrolled the Brookings Institution website for ideas and had to overcome his own political mistakes.

The story of the Affordable Care Act in some ways started at a candidate forum on health care in 2007 when Mr. Obama was running against Senators Hillary Clinton, John Edwards and Joseph R. Biden Jr., among others, for the Democratic presidential nomination. “Senator Obama was terrible,” remembered Neera Tanden, who worked for Mrs. Clinton at the time. “He was vapid. He had no facility with the issue, so he kept talking about, ‘This is why we need to come together.’”

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