The survey, taken Friday through Sunday, finds 42% against a bill, 35% in support of it. Despite nearly a year of presidential speeches, congressional hearings and TV ad campaigns by interest groups, more than one in five still doesn't have a strong opinion.

When pressed about how they were leaning, 49% overall said they would urge their member of Congress to vote against a bill; 44% would urge a vote for it.

The findings underscore the difficult battle ahead as President Obama presses Congress to enact the legislation by the end of the year. The House passed its version this month, and Senate debate on its health care bill is slated to start in earnest next week. A sharp partisan divide in public opinion helps explain the mostly party-line votes in Congress.

Those Democrats surveyed were overwhelmingly in favor of a bill: 76% to 17%. By an even wider margin, 86% to 12%, Republicans were opposed. Independents were against it by 53% to 37%.

Obama has seen his approval rating on handling health care policy slide a bit since the summer. Now, 40% approve, 53% disapprove, down from a 44% approval rating in July.

The poll of 1,017 adults, taken by landline and cellphone, has a margin of error of +/— 4 percentage points.