It's not just the economy, stupid

FORTUNE -- In the coming days and weeks, leading Democrats will make the case that their historic trouncing at the polls last night was the inevitable fallout of a brutal economy. In his press conference today the president -- pressed about public disapproval of his policies -- repeatedly referred to an "emergency situation'' that forced the need for a stimulus and the Detroit bailout. There's a bit of déjà vu here: George Bush blamed his plummeting approval ratings on an unpopular war.

In fact, the economy was only part of the equation. Deep dissatisfaction with President Obama's agenda -- and especially healthcare reform, his signature achievement, and one that has nothing to do with emergencies caused by the financial crisis -- fueled the intensity that has now given Republicans their biggest House majority since 1928.

State unemployment rates didn't determine outcomes. In California, home to the nation's second highest unemployment rate --12.4% -- Democrats held onto Barbara Boxer's Senate seat and put Jerry Brown in the governor's mansion. That last win is despite the fact that former eBay (EBAY, Fortune 500) chief Meg Whitman will have spent close to $190 million, more than any candidate in history besides Barack Obama. (Whitman's loss, by the way, puts her third -- behind Al Checchi and Michael Huffington -- among business titans who failed to win a statewide election in California despite record-breaking spending.) [For more on this subject, see: "California's electoral technophobia."]

In contrast to staunchly blue California, it was in the heart of the country -- states where a bad economy combined with anger over the Democratic policies -- that drove Republican momentum.

Most of those were the same states behind Obama's victory two years ago --swing states like Ohio (10% unemployment) and Pennsylvania (9%), as well as red states that supported Obama like Virginia (6.8%) and North Carolina (9.6%).

Neither the Obama's stimulus plan, nor healthcare, poll well nationally. But especially in these states voters tell pollsters they don't think spending nearly a trillion dollars of taxpayer money to boost the economy worked, and they oppose the massive healthcare overhaul that a Democratic Congress passed over the near unanimous objections of Republicans.

According to detailed polling by GOP firm Public Opinion Strategies, "Obamacare" has entered the American political lexicon with 89% of voters having an opinion on it. A plurality (47%) have a negative reaction to the term while only 29 percent have a positive reaction.

Not only that: a slim majority of voters, 51%, say an "acceptable" outcome of this election would be a repeal of healthcare reform. The numbers are even higher among independent voters, 60% of whom opposed healthcare reform.

It's little wonder that a number of Democrat candidates in moderate districts tried to distance themselves from the new law. West Virginia Gov. Joe Manchin -- who provided a bright spot for Democrats last night by winning a Senate seat -- promised voters he wanted to repeal the "bad parts" of healthcare reform.

Some 34 House Democrats voted against healthcare reform -- a few of them ran ads publicizing that vote -- and while it didn't make them bullet-proof last night, they tended to do better than those Democrats in swing districts who voted in favor of the bill.

All this is not to say that the economy didn't play a big role. A sharp drop in consumer confidence and feelings about the country's economic future settled in over the summer, according to the Michigan Consumer Sentiment Index. Keep in mind, too, that Republican Party approval ratings remain abysmal. Voters were casting ballots against the Democrats and their President as much as they were in favor of the GOP.

But elections turn on intensity. And among the independents who decide presidential elections, all that intensity was on the Republican side.

What does this mean for "Obamacare"? The House's soon-to-be speaker, John Boehner, has made it clear his chamber will pass legislation to repeal it. But that bill will sit like a stack of wood outside the Democratic-controlled Senate. And, of course, it will face President Obama's veto pen. (The president today indicated a willingness to nibble around the edges, like altering a requirement for small companies to file 1099 forms, but stood by the core of his reform.)

The real impact of this renewed brawl over healthcare could be outside Washington--on the judges who will decide the fate of a constitutional challenge to the law filed by attorneys general in 20 states. The voices of voters last night was loud -- and increasingly clear.