Washington: President Barack Obama hopes to start off his second year in office with a bang - a major health care reform bill that has eluded US presidents for decades.
The health reforms are hotly opposed by conservative Republicans, provoked angry protests by voters and sapped much of Obama`s political capital in the first year. Yet passage of a final bill would mark the biggest success of Obama`s young presidency.
Democrats hope to have a final reform bill sent to the President`s desk for signature by late January or early February, shortly after Obama celebrates the anniversary of his inauguration January 20.
"Universal coverage" failed to be enacted under many a former president, going all the way back to Teddy Roosevelt in the early part of the last century. This bill is designed to extend health insurance to about 30 million Americans who currently go without.
Critics believe Obama is achieving this goal through a dangerous expansion of the government, which they see as a sign of the far-left tendencies of his first year in office.
"President Obama is leading an extreme, left-wing crusade to bankrupt America," his erstwhile 2008 election opponent, John McCain, wrote this month in a message to supporters.
Obama, 48, insists that the reform that will help rein in skyrocketing health costs is an economic imperative. They currently consume more than 16 percent of the gross domestic product, the highest percentage in advanced economies.
Health care has been a tough slog and passage of the final bill, even after nearly a year of wrangling, is still not a foregone conclusion.
Final details are still being hammered out. The White House and Democratic leaders in Congress are busy melding two versions of Obama`s signature domestic legislation that were passed by the Senate and House of Representatives at the end of 2009.
The coming year is not likely to get any easier, or any less ambitious. The stepped-up military commitment to Afghanistan and the winding-down war in Iraq all demand attention on the foreign front.
The priorities at home are equally pressing: tackling climate change, overhauling financial regulation, comprehensive immigration reform and restoring jobs in an economy emerging from its worst recession in decades are all priorities for Obama.
But it is unclear whether Obama has the political strength or even the backing of his party to push for major reforms in 2010. Republicans, who have staunchly opposed most of Obama`s agenda, expect to make inroads during mid-term congressional elections in November.
"Looking just at the Senate, Democrats can now be fairly certain they aren`t going to have 60 seats anymore come 2011," wrote Larry Sabato, professor of the University of Virginia, in a 2010 forecast.
"A multi-seat gain for the (Republicans) in the Senate is now the best bet."
Obama`s popularity has plummeted since the inauguration. His approval rating sits around 50 percent, the lowest in modern history for a president entering his second year in office. This has some of his fellow Democrats running for the hills.
Senator Christopher Dodd of Connecticut, a long-time leader of the party, announced this month that he will not run for re-election in November. His reasoning sounded ominous for Democrats: Dodd was in "the toughest political shape of my career".
Senator Byron Dorgan of North Dakota also announced he wouldn`t run in November, while some other top Democrats including Senate Majority Leader Harry Reid face very tough re-election campaigns.
For Obama, success on the rest of his domestic agenda - and the fortunes of his party - could rest on the health of the country`s economy. Critics argue this should have been his priority all along.
Senator Ben Nelson, a key moderate Democrat who has been at the centre of the health care debate, suggested health reform should never have been attempted during the country`s worst recession in decades.
"I think it was a mistake to take health care on as opposed to continuing to spend the time on the economy," Nelson told a local newspaper in his home state of Nebraska.
In marking a poor unemployment report on Friday, which showed that another 85,000 jobs were lost in December and left the jobless rate at a stubborn 10 percent, Obama said of 2010: "We have to continue to explore every avenue to accelerate the return to hiring."