Nov. 17, 2009 -- President Obama is showing durability against significant economic and policy challenges, maintaining majority approval for his job performance in the face of broad unemployment, a controversial health plan and continued doubts about his work on the war in Afghanistan.

The trick's in personal appeal, a strong base of support, weak opposition and a teaspoon of sugar in some of the medicine the president's prescribed.

Click here for PDF with charts and questionnaire.

The last is notably so on health care reform. Negatives abound: Fifty-four percent of insured Americans think it'll increase their own costs; among all, 56 percent think it'll raise overall costs, six in 10 think it could shut down many private insurers and 61 percent oppose covering abortions in federally supported plans. For all that, sweetened by other, more popular elements, the plan's holding essentially at an even split, 48 percent in favor, 49 percent opposed.

Obama, for his part, has a 56 percent job approval rating overall, better than on any individual issue tested in this ABC News/Washington Post poll save one – 60 percent for his handling of international affairs. That makes his current foray to Asia look well-timed, playing to a strength while he's got difficulties at home.

Continued personal popularity helps; 61 percent of Americans have a favorable opinion of Obama overall, his lowest since before the 2008 election and down 18 points from his peak when he took office, but a positive rating nonetheless. Intensity, while diminished, also is still with him; "strongly" favorable views of the president exceed strongly unfavorable ones by 12 points.

Obama's solid in his base – an 84 percent job approval rating among Democrats, falling sharply to 50 percent among independents and a mere 18 percent among Republicans. Notably, he and his party continue to benefit from a floundering opposition, with, for example, a 16-point margin for the Democrats over the Republicans in trust to handle the nation's main problems.

Tellingly, Americans by 2-1, 61 percent to 31 percent, say leaders of the Republican Party are mainly criticizing Obama without presenting other ideas, rather than offering alternatives to his proposals. Independents, the center of politics, hold this view by 54-37 percent. And the ranks of independents are broad: They again account for a plurality of Americans, 39 percent in this survey, while Republicans, in the tank all year, make up just 21 percent of the population.

Republican Problems, More Trust Obama

Other measures underscore the difficulties facing the GOP, which has lost allegiance steadily since 2004, starting with fallout from the Iraq war and growing disenchantment with then-President Bush. The Democrats in this poll outnumber the Republicans by 10 points as the party that "better represents your own personal values" and by 15 points as being "more concerned with the needs of people like you."

Those attributes help soften the blow for Obama on a variety of issues, none more hazardous than the economy. Even while just 37 percent think his stimulus has helped, the public nonetheless trusts Obama over the Republicans in Congress to handle the economy by a 15-point margin, 52 to 37 percent. The GOP hasn't capitalized on his potential vulnerability.

It's similar on health care, an issue on which Obama has just 47 percent approval overall and, as noted, several specifics produce significant levels of public concern. For all those, Obama leads the Republicans in Congress in trust to handle health care by 13 points, 50 percent to 37 percent.

HEALTH – The "public option" component of reform is an example of how details matter. Overall 53 percent in this poll favor a government-backed alternative to private insurance in general, a modest majority down a bit from 57 percent last month. But support rises sharply, to 72 percent, if the option is limited to people who do not receive insurance from an employer or through the existing Medicare or Medicaid programs, as called for in the House-passed version.

Another popular element of the plan is the employer mandate – that is, requiring all companies with a payroll of at least $500,000 either to offer health insurance to their employees or pay money into a government fund that would provide assistance buying insurance to people who can't get it from work. Sixty-six percent of Americans like the idea.

These are among the elements that counter some significant concerns about reform. Six in 10 think it's at least somewhat likely that a government plan would force many private insurers out of business because they couldn't compete, although fewer, 30 percent, think this is "very" likely. It matters: Support for reform overall is 34 points lower among those who think a public option would damage private carriers.

Concerns about impacts on cost, in particular, are substantial. As noted 54 percent of Americans who currently have insurance think changes in the system will raise their costs, and among all adults 56 percent think reform will boost the costs of the health system overall. Both are strong predictors of opposition to the current reform plans. (Cost concerns peak among seniors.)

Abortion Coverage and Health Care Reform

Moreover, 37 percent think changes in the system will make their own care worse – a new high, up 5 points from September – while many fewer, 19 percent, think their care will improve. And there's an even broader division on the impact on health insurance coverage – 13 percent think it'll improve, 39 percent worsen.

These, however, leave substantial numbers, 42 and 46 percent, respectively, who think their quality of care and extent of coverage will be unchanged, and in those groups support for reform is substantial, 63 and 67 percent. There's also a fairly even split on whether support for reform will make care for "most people" better or worse (34 percent vs. 38 percent), another factor that mitigates some of reform's negatives.

Views on abortion coverage also underscore how details matter. Sixty-one percent say insurance policies bought using government assistance should not be allowed to include coverage for abortions. But if the insurance companies use private funds, not public money, in providing abortion coverage – the workaround some Democrats have proposed – support for allowing that coverage gains very sharply, up 21 points to 56 percent.

KNOWLEDGE, SUPPORT and VOTE – Given the complexities, it's perhaps surprising that a majority of Americans, 55 percent, feel they have a good basic understanding of the changes being proposed to the health care system. And this sense of knowledge works in favor of advocates of change: Support for the reform proposed by Obama and Congress rises to 56 percent among people who feel they understand the proposals, compared with 38 percent support among those who find the changes too complicated to understand clearly.

That said, views continue to break sharply along partisan and ideological lines; overall support, 75 percent among Democrats, drops to fewer than half of independents, 45 percent, with 52 percent opposed. Among Republicans a mere 13 percent support the proposal; not only are 85 percent of Republicans opposed, but are 73 percent "strongly" so. That helps opponents lead in intensity – among all Americans 39 percent strongly oppose reform, vs. 30 percent strong support.

The direction of that intensity is reflected, modestly, in a measure of vote impact: Twenty percent say they'd be much more likely to oppose a candidate who backed health care reform, vs. 13 percent much more apt to support one. Republicans overwhelmingly rate it as a strong negative, but it's also a factor among independents: Twenty-three percent much more apt to oppose a reform backer, 11 percent much more apt to support one.

Obama Approval: Economy, Afghanistan, Deficit

OTHER ISSUES – Holding the line on health care is far from Obama's only challenge. He's got a precarious 51 percent approval rating on handling the economy, and remains lower on dealing with two other top issues – Afghanistan, 45 percent approval, with 48 percent disapproving; and handling the deficit, 42 percent approving while 53 percent disapprove. On handling terrorism, 53 percent approve, but disapproval is up by 7 points to a new high, 41 percent.

There's also the public's general woe, fueled chiefly by the economy. Forty-four percent say the country's headed in the right direction overall, but a majority, 55 percent, says it's still seriously off on the wrong track, a number that's held steady since August after a spate of relative optimism in the spring and early summer.

It could be far worse – "wrong track" is down from a record 90 percent in October 2008. But it's a reflection of the public's continued economic pain and the hazard that poses for Obama, his in-power party and indeed all incumbents.

Just 38 percent in this poll say they're inclined to re-elect their representative in Congress; 50 percent instead are inclined to look around for someone else. That "look around" number has been higher, peaking at 58 percent before the 1994 elections in which the Republicans took control of the House. But it's also been as low as 41 percent. It's a reminder that for all the other issues facing the country, as goes the economy, likely goes 2010.

METHODOLOGY – This ABC News/Washington Post poll was conducted by telephone Nov. 12-15, 2009, among a random national sample of 1,001 adults, including landline and cell-phone-only respondents. Results for the full sample have a 3.5-point error margin. Click here for a detailed description of sampling error. Sampling, data collection and tabulation by TNS of Horsham, Pa.