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WASHINGTON — President Obama waged a fierce fight to pass his health-care law four years ago. But as his administration prepares to put it in place, he is facing an aggressive Republican campaign to prevent a successful rollout and to deny him his most important legacy.

Starting this week, the administration will kick off a six-month campaign to persuade millions of uninsured Americans to sign up for health coverage as part of insurance marketplaces that open for business Oct. 1. If too few people enroll, the centerpiece of the president’s Affordable Care Act could collapse.

Obama’s foes have intensified their opposition, trying to deepen the nation’s anger about the health-insurance program, which both sides often call Obamacare.

Republicans are eager to prevent people from enrolling, fearing that once people begin receiving the benefit they will be loath to give it up. In Washington, some lawmakers have cast the law as the evil villain in a legislative melodrama about the budget that is barreling toward a government shutdown.

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One group, Generation Opportunity, distributed a Web video last week showing a creepy-looking
Uncle Sam puppet peering between a woman’s legs at a gynecologist’s office. “Don’t let government play doctor,” the video says at the end. “Opt out of Obamacare.”

The administration is pushing ahead with a public-relations effort that will begin ramping up in earnest Monday, according to top aides in charge of the program.

Officials said the rollout would include an event next week in New York with former President Clinton and a health-care speech by Obama on Thursday in Maryland. First lady Michelle Obama will urge mothers and veterans to get their families enrolled. Vice President Joe Biden will host a nationwide conference call with nurses to enlist them in the effort to spread the word. Members of the president’s Cabinet will fan out across the country, lobbying constituent groups to prod their members into action.

Those efforts will eventually be augmented by a Madison Avenue-style advertising campaign by insurance companies, which officials say are poised to spend $1 billion or more to attract millions of new customers. Some of the ads are likely to be aimed at young people, many of whom are uninsured but healthy — and great for the insurance companies’ bottom line.

Liberal advocacy groups have also begun to organize door-to-door canvassing, much as they did on behalf of Obama’s two presidential campaigns.

The overarching goal is to persuade many of today’s 48 million uninsured to sign up for insurance on the new exchanges created by the law.

But as Obama’s campaign accelerates, Republicans at all political levels are working against the law. A Republican committee website counts down the days, hours, minutes and seconds until what it calls the “Obamacare Train Wreck.”

Other conservative groups are broadcasting TV advertisements that urge people not to sign up for the health-care law. Americans for Prosperity began broadcasting an ad last week featuring a cancer survivor who warns about the dangers of the law. It is the latest in a series of TV commercials featuring women criticizing the law.

“Obamacare is dangerous. It can’t be implemented,” Tricia, the cancer survivor, says in the ad. “Your well-being judged by a bureaucrat in D.C. is devastating.”

White House officials call the GOP efforts a “sabotage campaign” and concede that the assault on the law will make it harder to persuade people to sign up for insurance.

“It’s rather extraordinary, if you think about it, that there are efforts under way to prevent Americans from getting benefits that they lawfully could enjoy and should enjoy,” said Jay Carney, the White House press secretary.

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