Five hurdles for the health care bill

As I see it, the health care bill needs to pass 5 hurdles before it can become effective. The first four are obvious, the fifth is not.

1. It must pass the Senate.
2. It must pass the joint House and Senate committee.
3. It must re-pass the House.
4. It must re-pass the Senate.
5. Barack Obama must be reelected in 2012.
   

The major provisions of the bill are not designed to go into effect until 2013 or so. So it is possible to imagine a scenario in which the Democrats lose control of Congress and a Republican who opposes the health insurance reform gets elected president. And in this scenario, the reform could be dismantled before there is enough of an interested sector in society to oppose dismantling it.