Literally:

…for most of the three years since Obamacare was passed, the majority of the population has disapproved of it (see the second chart here at Real Clear Politics), yet that didn’t really translate into significant public anger or political action, beyond the 2010 mid-term election results. In fact, Sen. Ted Cruz’s filibuster attempt and the House’s short-lived shutdown appeared to push public opinion against those actors rather than against Obamacare.

But that has changed, and dramatically, with the law actually going into effect — and Healthcare.gov going live — back on October 1st. For the first time, Obamacare got “close enough” to significant portions of the American electorate to trigger a sudden shift in actual emotional response from a generic disapproval to outright hostility. I believe that Obama and his Administration — lulled, perhaps, by the more passive dislike evinced by the public up until now — have been caught genuinely off-guard by the dramatic change in public opinion in a month’s time, not just towards Obamacare but towards Obama himself. I believe that shift in fact represents a ‘catastrophe’ — that is, an abrupt transition from one state to another– brought on by the realities of Obamacare hitting home.

I don’t think there’s any precedent for a second-term president recovering from something like this.