I'm sorely tempted at this point to circle back to my earlier comments on a President's priorities being largely dictated by the events of the day/week/month.

Give in to the temptation!

But it's still wrong. Yes, events happen. But part of being a President - and especially part of being senior in the Administration - is to keep the President's priorities moving even though events happen.

It's not like there weren't events of the day/week/month during 2009. But because health insurance reform was Obama's top priority, work on the ACA continued apace. Note that other measures like EFCA and ENDA and the DREAM Act didn't make it through, which is why priorities matter (okay, I gave in to temptation too). But while Presidents are not immune to events, they also have to keep their Administration on track.

Note: sometimes that's not possible. Whatever President W wanted to be in his first term, 9/11 changed that. Whatever DJT wanted to do in his last ten months in office, Covid changed that. But a lot of the time, stuff like that isn't going on.