Presient Obama plans this week to step up his efforts on health care (capped with a primetime news conference on Wednesday), but a new Washington/Post ABC News poll finds that only 49 percent of Americans approve of his handling of health care, compared to 44 percent who disapprove. By comparison, back in April, the same poll found 57 percent approval to 29 percent disapproval. In other words, over the past three months, as Obama consistently pounded on the drum for health care legislation, his net approval on the issue has shrunken dramatically. And if you look deeper into the numbers, it gets even worse for Obama, because those who now strongly disapprove of his handling of health care outnumber those who strongly approve 28 percent to 22 percent.

While Obama remains broadly popular, with a 59 percent overall approval rating, that’s down from 65 percent last month. And this is part of a larger phenomenon — no matter the issue, the trend for Obama is south. Approval of his handling of the economy is now at 52 percent, compared with 60 percent in February and on the federal deficit, approval has dropped to 43 percent, compared with 52 percent in March. Now 56 percent say they’re confident Obama’s economic program will improve the economy, compared to 72 percent in January. Ironically for a president who was elected on economic rather than foreign policy issues, the approval of his handling of Afghanistan is holding steady at 62 percent.

There’s also evidence Obama is losing the image war. In March, just 32 percent said Obama was “an old-style, tax-and-spend Democrat” while 62 percent said he was “a new-style Democrat who will be careful with the public’s money.” But the public is starting to catch on to him, and 43 percent say he’s a tax-and-spend Democrat, and now 52 percent see him as an new brand.

Some other noteworthy findings: 61 percent say they oppose another stimulus package; 55 percent say it’s more important to avoid a deficit right now than increase spending to boost the economy;  and 54 percent say they would support a health care bill containing the major provisions of the House Democrats bill. But as Jake Tapper notes, “That’s not an incredibly high number, and that didn’t include any of the pushback language that for so long has worked so effectively on countering health care reform efforts.”

But before Congressional Republicans get too excited, they should keep in mind that their own approval ratings are still in the toilet at just 36 percent.