The grade people give Obama on health care also has worsened since July, when just 43 percent disapproved of his work on the issue.
The poll underscores how the president has struggled to win public support to reshape the nation's $2.5 trillion health care system and to put the brakes on a deep recession.
Forty-nine percent say they oppose the health overhaul plans being considered by Congress, compared to just 34 percent who favor them.
People are about evenly split over what lawmakers should do now on health care: About four in 10 say they should keep trying to pass a bill this year while about the same number say they should start over again.
Significantly, though, only about two in 10 say the health care system should be left as is.
There is a clear public desire for a bipartisan approach on the issue. Eight in 10 say it's important that any plan that passes Congress should have the support of both parties, while two-thirds want Obama and Democrats to try winning support from Republicans, who with few exceptions have opposed the Democratic drive.
Obama's marks are also poor on the economy, with 52 percent saying they disapprove of how he's handled that issue.
A similar number disapprove of his handling of taxes, some of which may rise to help finance his health overhaul. And 56 percent dislike his handling of the budget deficit, which has skyrocketed under the costs of the financial bailouts and a recession that has caused sinking federal revenues.
The survey of 1,001 adults with cell and landline telephones was conducted from Sept. 3-8. It had a margin of sampling error of plus or minus 3.1 percentage points.