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President Barack Obama discusses health care reform during a town hall meeting at Broughton High School on Wednesday in Raleigh, N.C.
By Deputy political director
NBC News
updated 7/29/2009 7:29:37 PM ET 2009-07-29T23:29:37

Despite his public-relations blitz over the past two weeks to promote his plans to reform the nation's health-care system — including holding two town halls on Wednesday — President Barack Obama has lost ground on this issue with the American public, according to the latest NBC News/Wall Street Journal poll.

Pluralities now say that the president’s health care plan is a bad idea, and that it will result in the quality of their care getting worse. What’s more, just four in 10 approve of his handling on the issue.

The poll also finds that Obama's overall job-approval rating has dropped to 53 percent. And it shows a public that has grown increasingly concerned about the federal government's spending as the administration defends its $787 billion economic stimulus and supports a $1 trillion-plus health-care bill.

“This is a president who needs a vacation,” says Democratic pollster Peter D. Hart, who conducted the survey with Republican pollster Bill McInturff. “His job rating is … certainly an acceptable mark. But if you look at it over time, it has [gone] south without a doubt.”

The good news for Obama, however, is that he remains the most popular politician in country, and Democrats continue to lead Republicans in the handling of several key issues, although the GOP has gained ground from a year ago.

But the poll, McInturff says, makes it clear that Obama — who had been gliding above the partisan fray — has come back down to earth. Conservatives and Republicans have moved away from him, while his numbers in the South and Midwest have declined.

“The question I asked back in February was: When does political gravity take hold?” he said. “The answer is in this survey. It is happening right now.”

The health insurance divide
That’s especially true on the issue of health care reform. As Congress works on its legislation and as Obama campaigns to get an overhaul enacted, 42 percent now say that the president’s plan is a bad idea, which is a 10-point increase since last month. Thirty-six percent say it’s a good idea.

In addition, 39 percent — a plurality — believe that Obama’s plan would result in the quality of their health care getting worse. That’s 15-point jump since April.

And just 41 percent approve of the president’s job on health care, which is nearly identical to Bill Clinton’s scores from 1994, when he failed to get Congress to pass health care reform.

But the poll — which was taken of 1,011 adults from July 17-20, and which has an overall margin of error of plus or minus 3.1 percentage points — also reveals a clear split between those who have private health insurance and those who don’t.

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Americans who have private health insurance disapprove of Obama’s job on health care by a 51-38 percent margin. Those who lack insurance, however, approve of his job, 52-29 percent.

Video: Health care push hurts Obama's ratings Also, when read the specifics of his goals for health care — like requiring insurers to cover those with pre-existing conditions, providing low-income families with subsidies to help them afford insurance, and raising taxes on the wealthy to pay for the subsidies — 56 percent say they support Obama’s plan. Only 38 percent oppose.

Hart, the Democratic pollster, thinks the Obama White House might see that finding as a silver lining in this survey. According to him, it means, “If I can get my message out, I am going to be there.”

Down on the stimulus, deficit
The public also has concerns with the progress of the $787 billion economic stimulus that Obama signed into law in February. In the poll, 43 percent believe the legislation was a bad idea, up 16 points since January. Just 34 percent say the stimulus was a good idea.

Indeed, the poll finds that the public’s top concern about Obama’s young presidency is that he has spent too much money, increasing the size of the deficit.

And now, according to the poll, Republicans find themselves with a six-point advantage over Democrats on the question of which party would do a better job of reducing the deficit. It’s the first time Republicans have led Democrats on this question since 1997.

Republicans also now have advantages on controlling government spending and taxes — which McInturff says could make Obama’s job to sell a health care bill (and the tax increases that would pay for it) more difficult.

Still, the Democratic Party maintains its advantages over the GOP on health care, energy, getting the country out of recession and the economy, although those advantages are smaller than they were a year ago.

Overall, the Democratic Party’s favorability/unfavorability rating is 42-37 percent, while the Republican Party’s is 28-41 percent.

Obama: policies vs. popularity
The NBC/Journal survey has Obama’s overall approval rating at 53 percent, which is down three points from last month (and which also equals the percentage he won in last November’s presidential contest).

His job approval in handling the economy is lower, at 49 percent.

Furthermore, 46 percent say they are “extremely confident” or “quite confident” that he has the right set of goals and policies, versus a combined 53 percent who say they are “only somewhat confident” or “not confident at all.”

But the president remains personally popular: 55 percent view him favorably, compared with 34 percent who view him unfavorably.

Also in the poll, more than 70 percent give Obama good marks for being easygoing and likeable, more than 60 percent say he has strong leadership qualities and 55 percent believe he’s improving America’s image around the world.

And despite the decline in his numbers, Obama is the most popular politician measured in the poll. Vice President Biden’s favorable/unfavorable score is 38-36 percent; House Speaker Nancy Pelosi’s is 25-44; former Republican Massachusetts Gov. Mitt Romney’s is 28-20; Secretary of State Hillary Clinton’s is 53-31; and former Alaska Gov. Sarah Palin’s is 32-43.

Palin and 2012
Palin stepped down from office on Sunday, and could be eyeing a presidential bid in 2012. But according to the poll, a whopping 67 percent of Americans — and 43 percent of Republicans — say they would not like to see her president someday.

By comparison, 50 percent of the public — and 33 percent of Republicans — say they don’t want to see Mitt Romney, another possible 2012 contender, become president.

Mark Murray covers politics for NBC News.

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