By late summer 2009, some of the people who had worked hardest to elect Barack Obama were beginning to doubt whether they believed in the changes the new president was advancing. The topic was health care reform, and what had started out in early spring as an exciting venture to restructure the health care system according to progressive principles had become, to some reformers, an increasingly bitter exercise in the disparity between words and deeds. In a Washington Post opinion piece, Peter Dreier and Marshall Ganz, who helped engineer Obama's grassroots campaign strategy, lamented how the president seemed to have forgotten his admonition made as a candidate that the only path to enduring social change was to organize against entrenched interests. Disappointed and worried progressive activists like Mike Elk, who had worked around the clock for months to help Obama carry Pennsylvania, echoed this sentiment in the blogoshere. Writing in The Huffington Post on behalf of hundreds of former campaign staffers, Elk implored the president not to drop a proposal for a publicly run health care option that would compete against private insurance plans, because doing so would amount to a major victory for the insurance industry and a stinging defeat for the progressive goal of affordable health care. Referencing the millions who worked to put Obama in office, Elk wrote, “Mr. President, we are here to say that there is only one force in this country more powerful than the insurance industry and its corporate allies – us! During the campaign, we defeated two of the strongest machines ever assembled in the primary and general election [Hillary Clinton and John McCain]. We can beat these guys too.”

Concordant voices could be heard at Daily Kos, the largest progressive community weblog and a hub of pro-public option activism. “Boy, oh, boy do I remember the fight to get President Obama elected,” blogged a former campaign organizer with the screen name HRCDemographic4Obama. “My experience working on President Obama's campaign teaches me he needs a strong reaction from Progressives. He needs to know we are willing to fight everyone, including him, for what is a moral obligation in a nation such as ours, universal health care.” While still regarding Obama as an ally, these individuals who had worked so hard to elect him were preparing to mobilize against him as they watched the president's rhetorical call for transformational change diverge from a governing strategy built around conventional politics. As Dreier and Ganz note,