A new poll finds 53 percent of people disapprove of ObamaCare and President Obama's approach to healthcare policy, a record high on both questions.
The survey from USA Today and the Pew Research Center also found Republicans have gained a narrow but telling edge on healthcare issues generally.
The poll revealed that 40 percent now prefer the GOP on healthcare compared to 39 percent who prefer Democrats, erasing a preference for Democrats that had stretched back more than 20 years.
About one-third (34 percent) reported that they do not understand how the healthcare law will work, a figure that has only slightly improved since the law's passage.
Meanwhile, nearly four in 10 of the uninsured do not realize they will be required to buy coverage or pay a fine starting next year.
This understanding is better among the general population, where seven in 10 grasp the so-called individual mandate, but worse among young people whose participation in the new exchanges is vital to ObamaCare's success.
Some have attributed the public's weak understanding of healthcare reform to Republicans' opposition to the law.
In Congress, the GOP has voted more than 40 times to repeal, defund or dismantle ObamaCare, and states run by Republicans have often worked against the administration to undermine the law's rollout.
The House GOP is debating how best to thwart ObamaCare during the next fiscal battle to fund the government.
Conservatives want to pass a spending bill that funds every part of the government except the healthcare law, hoping the imminent threat of a shutdown will force Obama to neglect the reform.
But ObamaCare's opponents do not necessarily agree on this tact, according to the poll. A majority (51 percent to 42 percent) said officials should help the law succeed instead of working to ensure its failure.
USA Today and Pew polled 1,506 adults between Sept. 4-8. The survey's margin of error is three percent.