Republicans aren’t in the ascendancy as they were in 1994. After two victorious election cycles, the Democrats have puréed the Republicans into their purest conservative caucus.

In a way, that made it easier for Republicans to vote against Obama’s stimulus plan. But a repeat performance on health care could be more complicated.

Health care is a personal issue for many voters. Reforming the current system ranks as the public’s third top priority, according to a January Kaiser Family Foundation poll. And many of those advocates aren’t traditional Democratic constituents.

“We are in a different game, and they are playing by the old rules,” said Stan Greenberg, a Democratic political strategist and former Clinton adviser.