A new Washington Post/ABC News poll finds President Obama's job approval down 12 points since April, as less than half of Americans are now confident in his leadership and ability to significantly improve the health care system.

The survey was conducted of 1,001 adults from Aug. 13-17 with a margin of error of +/- 3%.

Just 49% are now confident that Obama will make the right decisions for the country's future, down 11 points since April. Sixty percent of the 18 to 29-year-old voting bloc he dominated in the 2008 election still back him, while those 30 to 64 and 65 and older are below 50%.

On health care, more people now disapprove (50%) of the way he's handling the issue, compared to 46% who approve. While 58% say reforming the nation's health care system is necessary to control costs and expand coverage, just 45% support the changes being developed in Congress and by Obama. At the same time, 52% support the development of a government health care plan to compete with private insurance; 46% oppose it.

Obama's 57% job approval, higher than other recent polling, bumps his RCP Average back up to 52.0%.

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