President Obama's job approval ratings have fallen more steeply than any other newly elected president, and the White House is well aware that drop could impact the president's ability to advance his agenda.
As he faces a skeptical public and pushback from the GOP on his health care reform efforts, the president will address a joint session of Congress during primetime on Sept. 9 to try and regain momentum and convince Americans that his health care prescription is the right one. The president was invited by House Speaker Nancy Pelosi, D-Calif., and Senate Majority Leader Harry Reid, D-Nev., to address the joint session on health insurance reform.
Senior adviser David Axelrod told ABC News the president will try to regain control over the discussion, move aggressively to pass legislation through Congress, and make direct personal appeals to members of Congress.
"We're at a point in this debate where we've been talking for months and months, all the ideas are on the table," Axelrod said. "Now we have to pull those strands together and deliver an overall vision of where to go."
In coming days, Axelrod added, the president will use his "megaphone" to convince Americans on the details of reforms needed and is even considering an address to the nation from the Oval Office.
The health care reform debate is entering a new phase, a White House official said, "driven in part by the actions of some in the GOP, including Sens. Chuck Grassley and Mike Enzi, which indicates that they are essentially walking away from the negotiating table." It seems likely that the White House will give up on any hopes that the bipartisan "Gang of Six" senators working in the Senate Finance Committee will produce legislation that will advance the process.
In recent days, both Republican senators have assailed the president's health care reform efforts. Wyoming Sen. Enzi tore apart the Democrats' health care proposal in this weekend's GOP radio address, saying it would "raid Medicare," will interfere in Americans' medical care and "will actually make our nation's finances sicker without saving you money."
Grassley, R-Iowa, at the center of bipartisan discussions in the Senate as the ranking minority member of the Senate Finance Committee, recently sent out a fundraising letter in which he asked for voters' "immediate support in helping me defeat Obama-care."
"Those were unfortunate comments. They didn't – they weren't encouraging," Axelrod said.
Obama's job approval in the daily Gallup poll currently sits at 50 percent. If it dips any lower before November, it would be the second-fastest drop of an elected president to below majority approval since World War II, behind only President Bill Clinton.
The president's popularity at the start of his term was high, at 68 percent, but he was faced with numerous challenges coming into office, including a recession and unpopular wars abroad.
"You have to remember that President Obama started from significantly higher rate," said presidential historian Mark K. Updegrove. "He was bound to slip."
"There was this great good will we saw with President Obama. It was bound to decline, given the enormous burdens he faced as president shortly into his term," Updegrove added.
Clinton, whose own health care overhaul push in his first term was unsuccessful, fell below 50 percent approval four months into his presidency because of controversies such as Travelgate and issues like the debate over gays and lesbians serving openly in the military.
Responding to the poll numbers, a senior White House official told ABC News, "If we only did what was popular in polls, the banks would have failed, there would be no domestic automakers, and we'd pull all our troops out of Afghanistan tomorrow. But none of those decisions would be in the economic or national security interests of the country."
Adding to Obama's problems are an increasingly unpopular and costly war in Afghanistan and his own struggles with health care reform.
"Health care has been a vexing issue for all modern presidents," Updegrove said. "For those few bold enough to address it, it's been an albatross."
"Health care reform is an easy issue to exploit because of its inherent complexity. The political opposition can use that ambiguity and complexity to their own political ends, and I think that's what you're seeing with President Obama."
Low job approval ratings could impact the president's ability to get anything done this fall. Even Democrats are practically begging the president the improve his game on health care reform.
"I think the president's got to decide in a sense, and he has, and to step up and really frame this again for us," Sen. Chris Dodd, D-Conn., said on NBC's "Meet the Press" Sunday. Dodd is the acting chairman of the Health, Education, Labor and Pensions committee, which drafted a Senate health care reform bill.
Rep. Anthony Weiner, D-N.Y., agrees the president needs to do a better job on leading health care reform.
"I think that frankly, the president and the White House have not done a stellar job on messaging this," Weiner told ABC News. "We really do need presidential leadership here and we need it to be pretty tough."
Axelrod told ABC News the president would be more specific about what should be in the bill, beyond re-articulating principles.
"I think that people will have a very clear sense of his vision for how to bring stability and security to folks who have insurance and to help those who don't get the insurance they need."
The long-term implications are of President Obama's precipitous slide remain to be seen. Seven months into his term, President George H.W. Bush was at a high of 73 percent, but he was not reelected.
His son, President George W. Bush was at 61 percent at this point in his presidency, but is now known for the most unpopular second term on record.
Updegrove said Obama still has a chance to turn his ratings around.
"The American people like President Obama. They don't necessarily like his policies right now, but he does have the trust of the American people, and he does have the good will," Updegrove said.
With a tough health care fight still pending, difficult days likely ahead in Afghanistan, not to mention a looming flu pandemic, it doesn't look like Obama's job is going to get any easier in the coming months.