Anyone interested in the politics of HCR should check out Alan I. Abramowitz’s “Health Care as an Issue in the Midterm Election” at Larry J. Sabato’s Crystal Ball. Abamowitz, a TDS Advisory Board member, provides an updated analysis of whether HCR “has the potential to influence enough voters to affect the results of the House and Senate elections.”
Noting that “that the most important influence on voter decision-making in congressional elections is party identification,” Abramowitz argues that “the influence of an issue depends on the proportion of partisans on each side who disagree with their own party’s position. The potential of an issue to influence the outcome of an election is greatest when the proportion of cross-pressured partisans is much larger in one party than in the other party.”
Using this framework, Abramowitz taps recent Gallup poll data, obtained 3/26-28, in which respondents expressed preferences for generic Democrats or Republicans for House seats, along with their opinions about the HCR Act. Abramowiz found:

The first thing that stands out when one examines the results of this poll is the powerful influence of party identification on vote choice. Among all registered voters, 48% favored a generic Republican, 46% favored a generic Democrat, and 6% were undecided. However…well over 90% of party identifiers and leaning independents supported their own party’s candidate. There was almost no difference in this regard between identifiers and leaners…92% of Republican identifiers and 97% of Republican leaners favored a generic Republican while 95% of Democratic identifiers and 90% of Democratic leaners favored a generic Democrat.
When registered voters were asked about the effect of the health care law on their congressional vote, they divided fairly evenly: 40% said they would be more likely to vote for a candidate who supported the law, 46% said they would be more likely to vote for a candidate who opposed the law, and 13% said it would have no effect on their vote.
…These opinions were generally consistent with voting intentions. 75% of Democratic voters said they would be more likely to vote for a candidate who favored the law while only 8% said they would be more likely to vote for a candidate who opposed the law; 84% of Republican voters said they would be more likely to vote for a candidate who opposed the law while only 9% said they would be more likely to vote for a candidate who favored the law. Among undecided voters, 28% said they would be more likely to vote for a candidate who favored the law, 34% said they would be more likely to vote for a candidate who opposed the law, and 38% said it would have no effect on their vote.

Abramowitz concludes,

…Only a small minority of voters are cross-pressured on the issue of health care reform and…the numbers of cross-pressured Democrats and Republicans are about equal. Moreover, among undecided voters, there is a fairly even split between those saying they would be more likely to vote for a candidate who supports the law and those saying they would be more likely to vote for a candidate who opposes the law. Based on these results, there appears to be little potential for this issue to produce a shift in voter preferences. The main effect of health care as an issue would probably be to reinforce voters’ partisan preferences.

Regarding the voter enthusiasm factor, however, Abramowitz cautions that,

…So far this year most polls have found Republicans to be more enthusiastic about voting than Democrats and that was also the case in the Gallup survey. 71% of those supporting a generic Republican indicated that they were more enthusiastic than usual about voting this year compared with only 56% of those supporting a generic Democrat.

Certainly the ‘enthusiasm gap’ favoring Republicans is cause for some concern. But the flip side, says Abramowitz, is that “there appears to be more room for increased enthusiasm among pro-reform Democrats than among anti-reform Republicans.” Thus Dems stand to benefit from an effort to energize HCR supporters, as well as an educational campaign to increase their number.
All of which also suggests that the economy, particularly jobs, may well trump health care as the pivotal concern for midterm voters.