President Barack Obama and Vice President Joe Biden smile Tuesday in the East Room of the White House in Washington, before the president signed the health care bill. Doubted and deeply in need of a comeback, Obama had a political dream week: the biggest reform to health care in decades, an overhaul of college loans, and a U.S. deal with its old foe Russia to shrink the nuclear arsenals of both countries.

Washington ? Doubted and deeply in need of a comeback, President Barack Obama had a political dream week: a historic remaking of America’s health care system, an overhaul of how students pay for college and a groundbreaking deal with Russia to shrink nuclear arsenals.

The biggest foreign and domestic policy victories of Obama’s presidency positioned him to keep swinging big. He has fresh results to back up his argument that persistence pays. The White House’s thinking is that the burst of success, particularly in extending health coverage to millions more people, will carry over to other issues and show lawmakers, and perhaps foreign leaders, the value of sticking with Obama.

As a vindicated tone took hold in West Wing offices, White House press secretary Robert Gibbs put it this way: “Accomplishment demonstrates leadership and strength. And those are tangible currencies in Washington.”

Yet this town also is known for having a short memory, and the forces working against the president are considerable.

He has a combative relationship with Republicans. An exhausted public is looking for jobs. His political base wants action on energy and immigration. There’s a shrinking legislative window and the Democratic Party is wary of big losses in November.

How he moves ahead will show the country what else he thinks he can get done quickly and whether he can learn from a tough triumph.

‘Near-death experience’

Obama has a choice to make about the next phase of his presidency, said William Galston, a former domestic policy aide in Bill Clinton’s White House and now a senior fellow at the Brookings Institution. That phase runs between now and about August, when the campaign season for November’s congressional elections will consume even more of lawmakers’ time.

Obama can follow through on his promised shift back to the economy — pursuing more jobs bills and a revamp of Wall Street regulations — and then hone in on helping Democrats win election. Or he can add in aggressive campaigns to pass immigration and climate-change legislation this year.

The Obama White House “had a political near-death experience over health care the past few months. It turned out OK in the end, but it was a close call,” Galston said. “So I think they have to ask themselves: Do they think Democratic elected officials and the electorate have the stomach for a lot more controversy?”

The next big legislative goal is rewriting how the government regulates the financial sector, adding consumer protections and preventing a repeat of the 2008 meltdown. Obama hopes to have a bill to his desk by the fall.

As encompassing as the health care victory was for Obama and Democratic leaders, it took much longer than the White House envisioned. That had a cost.

Whatever Congress starts but does not finish this year will die. A new Congress will need to start fresh in 2011.

If history is a guide, Democrats will see their majorities shrink in the House and Senate after the midterm vote in November. That gives Obama even more impetus to push hard now. Already, he has pledged to do everything he can to achieve a bipartisan consensus on immigration this year — the same kind of all-in pledge he made on health care.

The relentless nature of the presidency gives Obama little time to soak in the health care victory. He already is spending his time, that most precious commodity, on the road to explain the new law.

Tense discussions with Israel’s prime minister took some of his time this past week. The nuclear arms deal with Russia finally came together. But even once it is signed, Obama faces a fight in getting it ratified in the Senate.

What’s next?

The success of the last few days has only emboldened Obama.

He taunted Republicans who began campaigning to repeal the health care law, saying in a pep-rally atmosphere in Iowa: “Go for it.” And then on Saturday, he announced plans to make his first 15 recess appointments for agency and board positions that normally require Senate confirmation. He blamed Republicans for holding him up and blew by them.

Obama’s public approval numbers have long slipped since his heady first days in office. But turning more promises into action can help.

About two-thirds of people see the health care bill as an accomplishment for Obama’s presidency, a CBS News poll found.

“I think he can use the momentum to do other things if they’re more on the micro-policy level, without big costs to the government,” said Stephen Wayne, a presidential scholar at Georgetown University. “One of these huge comprehensive programs per administration is about all we can do — or all the American public can take.”