Most Would Urge Their Representatives to Vote Against Health Care Reform

That figure is little changed from a Gallup survey earlier in the month, when the margin against the legislation was 48 percent to 43 percent. But it is a swing from early October, when 51 percent said they would want their representative to support reform legislation and 41 percent said they were against it.

But Gallup says that "opinion on the issue is far from settled." The 49-percent-to-44-percent margin against reform legislation is achieved when Gallup asked those who were initially undecided what their leaning was.

When leaners are stripped away, the result is 42 percent who would urge a "no" vote on reform legislation, 35 percent who would advise a "yes" vote and 22 percent undecided.

The poll also found that Americans disapprove of the way President Obama has handled health care policy by 53 percent to 40 percent, slightly more negative than his numbers were from July through September.