By Dan Balz and Jon Cohen
Washington Post Staff Writers

Public confidence in President Obamas leadership has declined sharply over the summer amid intensifying opposition to health-care reform that threatens to undercut his attempt to enact major changes to the system according to a new Washington Post-ABC News poll.
Among all Americans 49 percent now express confidence that Obama will make the right decisions for the country down from 60 percent at the 100-day mark in his presidency. Forty-nine percent now say they think he will be able to spearhead significant improvements in the system down nearly 20 percentage points from before he took office.
As challenges to Obamas initiatives have mounted over the summer pessimism in the nations direction has risen: Fifty-five percent see things as pretty seriously on the wrong track up from 48 percent in April.
But there has been a notable increase in optimism about the length of the recession: Half of all Americans expect it to be over within the next 12 months. In February just 28 percent said the recession would end that rapidly.
Obamas economic stimulus plan has come under attack from Republicans who say it has failed to bring tangible benefits. But in the poll almost twice as many say the program has made things better as say it has made things worse (43 percent to 23 percent) with a third saying the plan has had no effect.
The presidents overall approval rating stands at 57 percent 12 points lower than its April peak as disapproval has ticked up to 40 percent its highest yet. On specific issues Obama received more mixed marks. A majority 53 percent now disapprove of his handling of the federal budget deficit and his ratings on health care continue to deteriorate. On the marquee issue of the economy 52 percent approve of his actions unchanged from June.
Despite the decline in general confidence in Obama there is still little competition in the battle for public trust: Just 21 percent say they think congressional Republicans will make the right decisions for the countrys future while 35 percent have confidence in Democrats.
Disapproval of Obamas handling of the health-care issue reached 50 percent in the new poll the highest of his presidency and 42 percent of those surveyed say they now strongly disapprove of the way he is dealing with his main domestic priority. Views of the presidents actions on reform have dropped most sharply among seniors and independents.
The Public Option
The poll was completed just as a new debate about a public health insurance option erupted after administration officials appeared to signal their willingness to jettison the proposal as part of an eventual compromise. White House officials later insisted that there had been no change in their support for the public option as they sought to reassure Democrats furious about what they regarded as an administration cave-in.
In the survey 52 percent of Americans said they favor the governments creation of a new health insurance plan to compete with private insurers while 46 percent are opposed. That is a big shift from late June when 62 percent backed the notion and 33 percent opposed it.
The drop in support for the public option has been particularly steep among political independents the closely watched group so critical to the Democratic takeover of Congress in 2006 and Obamas victory last year. Two months ago independents supported the public option by a 2 to 1 ratio. Now 50 percent are in favor and 47 percent are opposed.
Seniors have also become decidedly negative toward the proposal: In June seniors were evenly split on the plan but now a majority strongly oppose the idea.
The momentum for any reform appears to have slackened as the debate has intensified with 51 percent now behind the notion that government action is needed to control costs and expand coverage and 46 percent seeing such measures as doing more harm than good. Two months ago proponents outnumbered opponents by a wide margin.
Obama faces an increasingly polarized environment as he campaigns for his health-care initiatives. Fifty percent of those surveyed say they oppose the set of proposals advanced by the president and congressional Democrats while 45 percent support them. Intensity is on the side of the detractors: Forty percent of all Americans strongly oppose the plans while 27 percent are solidly behind them.
Angry protests at some congressional town hall meetings have dominated the news over the August congressional recess. Just over half 51 percent of Americans see these demonstrations as appropriate while 45 percent call them inappropriate.
Eighteen percent of those polled say they feel angry about the health-care changes that Congress and the Obama administration are proposing. And about as many 15 percent say they are enthusiastic about them with the majority almost evenly divided between satisfied (32 percent) and dissatisfied (31 percent).
Positive feelings about reform drop significantly by age with 57 percent of seniors holding negative feelings including 29 percent who say they are outright angry.
Partisan affiliation plays directly into the intensity of feeling: Fifty-one percent of those who describe themselves as strong Republicans say they are angry while enthusiasm peaks at 40 percent among liberal Democrats.
A Skeptical Public
The lack of energy behind broad change stems in part from widespread skepticism that the proposed overhaul would make things better. Only 19 percent envision the quality of their care improving or their costs going down if the system is changed and few of those who now carry health insurance (the vast majority of Americans) say they think their coverage or costs would improve. Seniors are more than five times as likely to believe their care will deteriorate under projected modifications than to believe it will improve.
The overall drop in support for government action on health care is notable among political independents who now divide evenly between whether government reform is even necessary or would do more harm than good. Disapproval of Obamas handling of the reform issue has spiked to 57 percent among independents a new high with nearly half giving him strongly negative marks. Nearly six in 10 independents oppose the proposals.
There has also been slippage among independents on broader measures of Obamas presidency. His job approval among independents now stands at 50 percent the lowest level of his presidency. For the first time more independents strongly disapprove than strongly approve of how he is doing. His approval among independents is also below 50 percent on the economy the deficit and taxes.
Before Obamas inauguration 61 percent of independents expressed confidence in his ability to make the right decisions for the country. That number fell to 52 percent about 100 days into his presidency and now sits at 41 percent. Confidence in his judgment has also slipped substantially among seniors.
Looking ahead to the 2010 midterm elections half of independents say a congressional candidates support for the proposed health-care changes will not affect their vote but among the other half twice as many say they are less apt to back such a contender than say they would be more likely to vote that way. Seniors tilt even more negatively on the question.
The poll was conducted Aug. 13-17 among a random national sample of 1001 adults on both conventional and cellular telephones. The margin of sampling error is plus or minus three percentage points.
Polling analyst Jennifer Agiesta contributed to this report.