President Obama's climate change address at the United Nations disappointed some for its lack of specifics or a firm timetable on U.S. carbon limits -- making environmentalists the latest discontented Democratic constituency.
Since taking office, Obama in quick succession has dashed the hopes of lesbians and gays, labor interests, anti-war Democrats, Hispanics and others, in part by keeping his own counsel and rejecting a path that pandered to his party's various factions.
It's a risky move with the 2010 elections widely expected to return more Republicans to Congress, potentially making future legislative battles even harder.
"This is a president who is always seeking the path of least resistance and in many ways, he is politically amorphous," said Republican strategist Kevin Madden. "He is always trying to find that middle ground."
With health care reform as the central priority, the White House has sidestepped or delayed a range of other issues including gays in the military, making it easier for unions to organize workers, troop levels in Afghanistan, immigration reform, and more.
The administration is banking on traditional Democratic constituencies to stay with Obama. But one risk for the president is losing the sense of urgency among liberals that helped him to office.
Already, the Republican National Committee is outraising Democrats, posting $7.9 million raised in August with $21 million on hand -- a bump attributed in large part to donors fired up by the late-summer health care debate.
During the same period, the Democratic National Committee raised $6.9 million and reported $15.3 million in the bank, plus about $5 million in debt.
Campaign promises to repeal the Defense of Marriage Act and call for a repeal of the "don't ask, don't tell" policy on gays in the military remain unfulfilled.
The White House has not put its political muscle behind a bill that would make it easier for employees to unionize, a measure the president supports. A cap-and-trade climate bill Obama also supports is stalled in the Senate after passing in the House.
Obama promised to make immigration reform a priority of his first year in office, but put it off saying health care and the economy required attention first. Behind closed doors, the administration is assuring supporters that once health care is passed, they will tackle the other key issues.
But Matt Mackowiak, a Republican strategist and former Senate aide, said Obama's options get narrower after health care.
"The deficit picture is so bad right now, he is not going to be able to pass anything that costs money," Mackowiak said. "He made two promises -- to not raise taxes on anyone making over $250,00 a year and to cut the deficit in half in his first term. He can't do both."