WASHINGTON — Democrats won a major legislative victory Sunday with the House approval of the health care overhaul.

But will their legislative victory be tomorrow's political triumph — or will passage of the largest new social program since Medicare become a political albatross around the necks of Democratic incumbents from Michigan to Texas?

Public opinion surveys reveal the depth of the Democrats' challenge. A CNN/Opinion Research Corp. poll released Monday found that 39 percent of American voters approve of the Democratic approach to health reform, while 59 percent disapprove.

"The decision by President (Barack) Obama and the Democrat-led Congress to ignore the voters and ram their government takeover of health care down the throats of the American people will come at a steep political cost in November," predicted Rep. Pete Sessions, R-Dallas, chairman of the National Republican Congressional Committee.

There's little doubt that Republicans have shaped the public relations battle over the past year. The challenge for Democrats is to change voters' perceptions of the legislation.

Here are some questions likely to predict which vision of health reform takes hold in the public consciousness:

• Will the new law be seen as the most important social policy achievement of the past half-century or a major step toward a government takeover of one-sixth of the U.S. economy?

"This is not about health, and it's certainly not about care," said Rep. Ted Poe, R-Humble. "This is about government control over every aspect of our lives without accountability and against the will of the people."

The White House disagrees, saying the legislation empowers individuals rather than expanding government.

• Will health reform end up costing or saving us money?
The nonpartisan Congressional Budget Office estimated a $143 billion savings over the next 10 years as a result of the Obama-backed plan. Republicans will focus on the new taxes contained in the bill, covering everything from tanning salons to high-income taxpayers.

• Does health reform help or hurt seniors?
Republicans are hammering Democrats for the bill's cost savings in Medicare. Democrats say they are squeezing waste out of the system and that seniors will get more — not less — coverage. AARP backs the plan and will act as a blocking back for Democrats among seniors.

A. Barry Rand, chief executive of AARP, said it is "crucial to all older Americans and their families." Richard S. Dunham