The new Washington Post-ABC News poll finds President Obama’s approval rating is at an all-time low (42 percent). Opposition to the Affordable Care Act is at an all-time high (57 percent). And by a margin of nearly two-to-one, those surveyed oppose an individual mandate.

There’s also this: for the first time in Obama’s presidency, a majority of Americans say they have an unfavorable impression of him (52 percent). Half or more of those surveyed say he is not a strong leader, he doesn’t understand the problems of “people like you,” and he’s not honest or trustworthy.

There’s more data to pore through, but suffice it to say that all of it is ugly for the president.

One of the harder things to do in politics is to distinguish between moments that at the time seem important but are in fact transitory versus those that are genuinely meaningful and durable. In this case, are the problems the president faces simply a bad patch he’ll recover from, or is his presidency sustaining profound and permanent damage?

Time will tell, but I suspect it’s the second of the two scenarios. I say that for several reasons, the first having to do with rank incompetence.

The list of failures of the Affordable Care Act is quite a long one, including (but not limited to) delaying the employer mandate, sticker shock as many people discover they will be paying much higher premiums and deductibles, the disastrous rollout of the federal government’s healthcare website, and the millions of people who have been forced to drop the coverage they want (thereby causing Mr. Obama’s desperate volte-face last week, when he announced he would take executive action that would allow insurance companies to offer the old plans for an additional year).

This kind of ineptitude would hurt the president on any matter; it is particularly damaging when it happens to his signature domestic achievement. So it won’t be easy for Mr. Obama to shake the reputation he has now earned as a bumbling amateur.

The second reason the Obama presidency is caught in a dangerous downward spiral is that the Affordable Care Act’s problems are likely to get worse, not better. The website will clearly not be running well by the end of this month. The odds of a “death spiral” (in which the vast majority of people who sign up for the ACA’s health insurance plans are sick, causing premiums to skyrocket) are growing by the day, we’re likely to see price hikes, and more cancellations of policies will occur prior to the mid-term election, (for more, see this story).

What the president desperately needs is a circuit breaker from the problems of ObamaCare. What he’s likely to get are multiplying problems. Things that are broken won’t be repaired any time soon–and new problems will arise. This will increase panic among Democrats, many of whom will begin to break with the president (we’re already in the early stages of this). And this, in turn, will further the impression of chaos and disorder, further undermining Mr. Obama’s reputation for competence.

The third reason the president’s problems are likely to worsen is that his personal credibility has been badly damaged. Mr. Obama misled the American people in such an obvious way, on so many different occasions, on such a large issue, that he is no longer deemed to be trustworthy or honest by a majority of the public.

This is, I think, a huge blow to the Obama presidency. Remember: What has always kept Mr. Obama afloat, even when his programs were not particularly popular, was the good will he had generated among the American people. Even if they disagreed with him, many Americans were drawn to Obama, inclined to give him the benefit of the doubt. No more. And when the bond of trust between a president and the public is ruptured, when his integrity is severely tarnished, it becomes very difficult to recover.

Is it possible for Mr. Obama to right the ship? Of course. Outside events can intervene, for one thing. And perhaps the Affordable Care Act will become a model of efficiency and beloved by a majority of Americans over time. But I have always been skeptical that would occur, since in my judgment the problems afflicting it are fundamental, systemic, and not really fixable. The ad hoc “solutions” the Obama administration is coming up with on a weekly basis seem to confirm that view.

We should know within a matter of a few months whether this period we’re now in will fade away and give way to better times–or whether it’s part of a long, downward slide for Mr. Obama, one that blows apart his reputation and undermines that cause of liberalism.

The left should be alarmed because right now it looks for all the world like it’s the latter.