The U.S. leads the pack in the percentage of older adults who have trouble paying their medical bills.
The botched rollout of Obamacare has opened up a two-front credibility crisis for the White House, with voters wary both of President Obama's promises and the ability of the federal government to solve Washington's most intractable problems.
The administration has been on the defensive over Obama's repeated claims that Americans could keep their insurance plans under Obamacare if they liked them.
Even more vexing for the White House though is creeping distrust among voters that federal agencies can deliver the sweeping policy agenda Obama promised in February's State of the Union.
Amid the embarrassing rollout -- and with little to show from the first year of his second term -- Obama is at risk of being tuned out by voters just as he needs their support to pursue his ambitious slate of domestic reforms.
"The president, and by extension all Democrats, have spent years arguing that government is not some boogeyman, that government can rise to the challenge and get the big stuff done," said one veteran Democratic strategist with close ties to the White House.
"I still believe in that message. But if they don't clean up this [Obamacare] mess, it's way worse than just a problem for the president personally. It undermines the entire Democratic brand, fosters more cynicism in government and weakens progressive arguments on a range of other issues," he added.
Obama earlier this year gave an unabashedly liberal State of the Union address, resurrecting his calls for an increase in the minimum wage, climate-change legislation, gun control and immigration reform. It was all part a broader push for a more active government.
The president is defending that blueprint even as the administration faces an onslaught of questions over its handling of the most comprehensive overhaul to the health system in 50 years.
"What I want to just remind people of is that this government is an enormous enterprise," Obama told activists for Organizing for Action, a political advocacy group formed from his 2012 campaign. "All kinds of changes are happening."
But the president has seemingly run into one concrete wall after another -- many of his own making.
His State of the Union proposals were swiftly swept aside on Capitol Hill. The administration also struggled to deliver a cohesive message on the bloody civil war in Syria, and a deluge of leaks about National Security Agency surveillance stoked fears about domestic spying, distracting the White House from its agenda.
The launch of Obamacare's public exchanges, a keystone of his signature legislative achievement, worsened the president's political headaches rather than relieving them.
The dismal stretch for Obama has left some voters, even those supportive of the president's agenda, fed up with the lack of progress and disillusioned by lofty pledges that have gone unfulfilled.
"I'm not some Tea Party type; I gave the president a fair shake," said Keith Evans, an information technology specialist from Arlington, Va. "But honestly, I just don't buy what the president is selling right now. This health care disaster was the tipping point for me."
If the president doesn't quickly correct course, questions about his credibility could turn into hardened perceptions, political analysts warn.
"Obama reminded me of those horrible press conferences with [President George W.] Bush where he was trying to pretend the Iraq War was not going poorly," said Jeremy Mayer, a political scientist at George Mason University, of the president's response to the stumbling Obamacare rollout.
"It's a problem for any president being caught saying something the average citizen doesn't believe to be true," Mayer added.
Obama's daily approval numbers are hovering around 40 percent, according to recent Gallup polls -- ratings strikingly similar to Bush, his Republican predecessor, at the same point in his second term.
Those numbers showcase an erosion of support among those who gave Obama emphatic electoral victories in 2008 and 2012, analysts said, pointing to left-leaning and independent voters.
"It's the people in the middle, those who are undecided about whether government is a plus or minus, that are going to be most affected by the Obamacare problems," said Martin Medhurst, a Baylor University expert on presidential communication.
White House officials counter that Obama will sink or swim not because over healthcare.gov's early woes, but on how Americans ultimately view Obamacare.
"We are going to look back a year from now," Obama pledged to supporters on Nov. 5, "and the American people are going to understand."
"We are going to make sure that every single person in this country can get affordable health care," he vowed.