Read: Trump has no room for error in 2020

But Trump’s treatment of health care was very different. Though he was just as assertive in his tone, the president made a series of false claims—in particular, he repeatedly lied about his administration’s unrelenting efforts to gut the Affordable Care Act. To Democrats, Trump’s determination to surround his health-care record with what Winston Churchill once called a “bodyguard of lies” clearly signaled that the president recognizes how vulnerable his record could prove this fall.

Polls leave little doubt that voters express much more positive assessments of the economy than the health-care system. “Because people see health care as so central to both their personal well-being and their financial well-being, health care stands out as Trump’s No. 1 vulnerability,” says the longtime Democratic pollster Geoff Garin. “The simplest way for people to understand the Trump economy is that whatever wage increases they are getting are smaller than the increases in their health-care premiums and out-of-pocket health-care costs.”

Over the past year, voters’ optimism about the economy has increased consistently across a wide array of polls. With this tailwind, the share of Americans who approve of Trump’s handling of the economy has also increased, settling in at about 55 percent. As I’ve written, Trump faces more resistance than any previous president among voters satisfied with the economy; about one-fifth of those who say they approve of Trump on the economy still say they disapprove of his overall performance.

But even so, that still means that most voters who approve of Trump’s economic performance approve of him overall. As Trump’s ratings for managing the economy have increased, so have his overall approval ratings. Just this week, Gallup showed his job approval spiking to 49 percent, its highest rating ever for him—although other polls have not recorded as dramatic an increase.

But the public assessment of Trump’s performance on health care tells a different story. In an Associated Press/National Opinion Research Center survey last month, just 38 percent of Americans said they approved of his record on health care—a grade that has stayed relatively stable since he took office—compared with 56 percent who approved of his handling of the economy, the highest of his presidency.

The latest monthly health-care poll from the Kaiser Family Foundation drilled down further into those views. In the survey, just about a third of adults gave Trump positive marks for dealing with preexisting conditions, the ACA, and prescription-drug costs. Detailed results provided to me by Kaiser showed that two key groups of swing voters shared this deep skepticism of Trump’s health-care record. A majority of college-educated white men disapproved of how Trump has handled each of the three issues. And while white women without a college degree—a group that could decide the Rust Belt states that tilted the 2016 election to Trump—broke against him more narrowly on the ACA and preexisting conditions, just 31 percent of them gave him positive marks on prescription-drug costs.