The entire time period of dissipating his mandate on healthcare for a Republican Party that acted like Lucy to his Charlie Brown. He'd constantly make changes and they'd just refuse to vote like they were always going to. Olympia Snowe owned him so hard it wasn't even funny. He acted like the Republicans would actually give way, ever, on anything.
They were never going to give him a single success he didn't force on them. After that he took it personally. It wasn't actually personal but it gave him his second election. The cost is a mediocre healthcare plan and a Presidency nowhere near as significant as Clinton's. Clinton carefully turned the Republican Congress's desire to actually achieve something into Democratic Congressional gains. Obama has reduced Democratic power.