Opposition hits new highs: 53% disapprove of the health care law, the highest level since it was signed; 42% approve. By an even wider margin, intensity favors the opposition; 41% of those surveyed strongly disapprove while just 26% strongly approve. Fifty-three percent disapprove of Obama’s handling of health care policy, an historic high. And Democrats have lost their traditional advantage on the issue. For the first time in polling that stretches back more than two decades, Americans narrowly prefer Republicans in dealing with health care policy, 40%-39%.

A boost in approval for the law that followed the Supreme Court decision in July 2012 upholding most of its provisions, to 47% approve-43% disapprove, has disappeared.

Confusion continues: Only one in four say they understand the law’s impact on them and their families well while one-third say they have little or no understanding about how the law will work. Despite increasing education efforts by the administration, advocacy groups and some states, the percentage of Americans who don’t understand the law has declined only modestly, to 34% from 44%, since it was passed.