The phrase is a bit tricky, as sometimes people will use the phrase sarcastically. They will say "I could give a damn!" which means they really don't care about whatever it is. They *could* conceivably care, but they don't. That way of saying it is a bit rarer, but it sometimes means the same as "I don't give a damn!"
Like HLO mentioned, there are many varieties of this phrase, another vulgar variation is "I couldn't give two f*cks." I rather like that one..