When it comes to health care reform it is amazing how times change – how polls change – how politics stays the same.
A year ago today , when President Obama signed his national health care plan into law the polls showed most American opposed to it. The bitterness born of phony charges of “death panels,” angry seniors complaining about possible cuts in Medicare benefits and Tea Party marchers screaming at members of Congress had much of the nation in a tizzy.

Now public opinion on the bill has taken on a sunny outlook. More Americans have a favorable view of the bill than have an unfavorable view. According to a Gallup poll earlier this month, 46% of Americans think it was a “good thing” while 40% think it was a “bad thing” with 10% undecided.

But as I mentioned, while the polling on Obama’s health care reform may have changed in the last year, the politics have not changed.

The lack of credible Republican alternatives for fixing a broken health care system that was driving big business and families into financial trouble has not changed. When asked what they do would instead, the GOP responds with the same tired, discredited talking points they used one year ago.

They still talk about the need for tort reform even though medical malpractice insurance premiums account for less than one percent of all health care costs. They still talk about the need for competition across state lines even though this would create a veritable race to the bottom as insurance companies are sure to move to the states with the least regulation so they can provide the lowest quality of coverage at the cheapest price.

The GOP has also derided the law as unconstitutional because it effectively forces people to buy health insurance ignoring the fact that government makes everyone pay taxes, issues everyone a Social Security card, and has been forcing people to buy auto insurance for decades. Republican state Attornies General have their knickers in a knot over this and their lawsuits will likely end up in the Supreme Court. The only way the court rules against the new health care plan is if the vote is along purely partisan lines and that will be a bigger tragedy for the court than for the rest of the nation.

The bigger issue on the table at the moment is that House Republicans have not passed a single alternative health care reform bill since they have been in charge but they have passed bills to repeal and defund the law. All of these bills, however, are dead on arrival in the Senate making the whole exercise futile and symbolic.

At a meeting of the nation’s governors last month, President Obama called the GOP’s bluff on health care. He challenged GOP governors -- like South Carolina’s Nikki Haley and New Jersey’s Chris Christie who have echoed party line complaints against what they call “ObamaCare” -- to come up with their own health care plans that meet the goals of the Affordable Care Act.

He challenged the governors, saying, "I am not open to re-fighting the battles of the last two years, or undoing the progress that we’ve made. But I am willing to work with anyone — anybody in this room, Democrat or Republican, governors or member of Congress — to make this law even better; to make care even better; to make it more affordable and fix what needs fixing."

That includes not driving up the deficit. So the president opened the door to the states, as what he called the laboratories of democracy, putting their own ideas on the table for reducing costs, increasing access and improving quality.

Since then, the silence has been deafening and the American people are beginning to see that the GOP really doesn’t have any alternative ideas on health care that fit the bill.

Keep in mind that many of the most consequential parts of the Obama health law will not take effect until 2012, 2013 and 2014. Keep in mind that several companies have had to request waivers to continue coverage for low-income workers. The health care bill is still a work in progress. The jury will be out until at least 2014 on the public reaction to the full implementation of the law. But a year ago the critics predicted the sky was about to fall and lack of public support for health care reform would doom President Obama. It didn’t. Obama’s latest approval numbers are about 50 percent and health care is nowhere near a dominant, doom issue.

For the sake of the Republican presidential nominee who will have to debate Obama on health care during the 2012 campaign next year, they had better come up with some. Oh, wait, Mitt Romney did just that when he was governor of Massachusetts. And now he is having to distance himself from his signature accomplishment because the official Republican stance remains to use that issue as a political truncheon to beat up the President.

Well, maybe now Obama can get some medical help.

Juan Williams is a writer, author and Fox News political analyst. Click here to read his recent five part piece for Fox News Opinion on "The Children of Juarez" His most recent book is "Enough: The Phony Leaders, Dead-End Movements, and Culture of Failure That Are Undermining Black America--and What We Can Do About It.