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Romney replied that the Massachusetts plan differed in fundamental ways from the federal one. Then he tried to turn Santorum's charge back on him.

"The reason we have Obamacare is because …Arlen Specter, the pro-choice senator of Pennsylvania that you supported and endorsed in a race over Pat Toomey— he voted for Obamacare. If you had not supported him, if we had said 'no' to Arlen Specter, we would not have Obamacare. So don't look at me. Take a look in the mirror."

Opposition to the federal law is nearly uniform among Republican voters. In the battleground states, eight in 10 say passage of the law was "a bad thing." Nearly six in 10 want it repealed. Nine in 10 say the law's provision requiring Americans to have health insurance or pay a fine is unconstitutional — the centerpiece of a challenge before the Supreme Court.

The issue is whether Congress can force people to buy health insurance or pay a fine, a mandate that the law's architects say is critical for the goal of expanding coverage and one that has divided judges on federal appeals courts. Arguments before the high court are scheduled to begin March 26, three days after the second anniversary of the law's signing.

Voters in swing states stand overwhelmingly on one side of the debate: Three of four voters, including a majority of Democrats and of liberals, say the law is unconstitutional.

That reaction is almost instinctual, says Stuart Altman, a professor of national health policy at Brandeis University who has joined two briefs supporting the law. "People say, 'The government should not mandate that I have to do anything.' "

He faults the Obama team for not responding effectively enough to what he calls a "torrent" of opposition and misinformation.

"You have this drumbeat of negative comments and almost no positive," he says. "You're relying on the president to do the selling, and he's moved on to other things. The congressional people on the Democratic side are not supporting it. They're either being very quiet or running away from it themselves because they're afraid of getting tarnished."

"That debate will be had," says Stephanie Cutter, Obama's deputy campaign manager. When the public is engaged in the general election, "there will be an intensive effort to ensure that families understand how they're already benefiting from the law and what would be taken away from them if Mitt Romney or Rick Santorum has their way. The American people do not want to go back to the days of insurance companies discriminating against you if you have a pre-existing condition or dropping your coverage if you get sick."

That will be a hard sale to make to Hargrove, the North Carolina truck driver. He acknowledges there are provisions in the law he calls "good and needed." His 4-year-old son, Matthew, was born with a hole in his heart, requiring expensive surgery. Hargrove notes that the law's bar on insurers refusing coverage to those with pre-existing conditions could protect kids such as his.

"But the way it was done, passed before it was read and all this other stuff, that's underhanded," he says. "You've got to have it or pay a penalty? That's not the way the country was set up."

Wariness about the future

Gail Wilensky, a top health care policymaker for President George W. Bush and critic of the law, says Americans remain wary of the long-term impact of its provisions, which don't go fully into effect until 2014. At this point, she says, "they are not seeing much in the way of positives, and they are concerned about the negatives it might have."

Eleven percent of voters in battleground states say the law has helped their families; 15% say it has hurt. Looking ahead, they predict by 42%-20% that the law will make things worse rather than better for their families.

A pocket of support: those under 30, a critical age group for Obama in 2008. They are inclined to call the law's enactment "a good thing." Even among them, the share of supporters falls just short of 50%. The older the age group, the more opposition emerges.

Opposition to the law is eroding Obama's support among the middle-of-the-road voters both nominees will court this fall. Among independents, 35% say the law makes them less likely to support Obama, more than double the 16% who say it makes them more likely.

The intensity of feeling among potential swing voters also favors opponents. Among independents who lean to the GOP, 54% say they are much less likely to support Obama as a result. Among independents who lean to the Democrats, 18% say they are much more likely to support him.

Jason Carr, 40, a federal public defender in Las Vegas who describes himself as a moderate, credits the Obama administration with addressing a problem people had been talking about for decades. "You may not like what they did, but they did something," he said in a follow-up interview after being polled. He is likely to vote for Obama in November but would consider Romney if he was the Republican nominee.

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