WASHINGTON -- Amid a budget debate that will affect the health care of virtually every family, a new poll finds support for President Barack Obama's overhaul at its lowest level since passage last year.
But in a ringing defense of Obama's policies, Medicare chief Donald Berwick pleaded Tuesday for more time on the health care law, and branded a leading Republican plan "unfair and harmful" and "a form of withholding care."
The Associated Press-GfK poll showed that support for Obama's expansion of health insurance coverage has slipped to 35 percent, while opposition stands at 45 percent, with 17 percent neutral.
That nearly ties the previous low in September 2009, when after a summer of heated town hall meetings dominated by critics, only 34 percent supported Obama's approach.
The worry this time appears to be federal budget deficits driven by unmanageable health care costs. Among seniors, whose views are critical in any debate over health care, support for the law dipped below 30 percent for the first time in AP-GfK polling.
Obama is scheduled to deliver a major speech at 1:30 p.m. today that will lay out his path for reducing deficits. While administration officials have acknowledged the need for more savings from Medicare and Medicaid, congressional Republicans have offered a bold alternative to tackle health care costs.
House Budget Chairman Paul Ryan, R-Wis., is proposing to convert Medicare into a "premium support" program. Instead of traditional Medicare, people now 54 and younger would get a fixed payment, or voucher, from the government to buy private health insurance when they retire.
Medicaid, which serves low-income people, would be turned over to the states as a block grant program. Taken together, the programs serve about 100 million Americans.
Berwick, who oversees Medicare and Medicaid as well as the rollout of the new health care law, said Tuesday that the Republican approach would set back efforts to improve quality and squeeze waste.
It would be like "giving people a sum of money and saying, 'Good luck, God bless you,' " Berwick said. "That's not about improving care. That's about shifting burdens."
Ryan said his plan will save Medicare from bankruptcy, and market competition will bring down costs without compromising quality.
The poll showed the administration's message isn't getting through, particularly with seniors.
Fifty-nine percent of seniors oppose the new health care law, while only 29 percent support it. Disapproval of Obama's handling of health care among seniors has ticked upward to 62 percent, while Republicans are more trusted than Democrats to handle the issue, by a 51 percent to 36 percent margin.
By contrast, among adults of all ages, Obama's approval rating on health care stands at 52 percent, and 53 percent said they trust Democrats to do a better job.
The Associated Press-GfK Poll was conducted March 24-28 by GfK Roper Public Affairs and Corporate Communications. It involved landline and cell phone interviews with 1,001 adults nationwide, and has a margin of sampling error of plus or minus 4.2 percentage points.