Speaker takes on Medicaid standoff

House Speaker Andy Tobin has emerged as the key player in getting Gov. Jan Brewer's Medicaid expansion plan through the Legislature, and momentum may be shifting in the nearly dormant Capitol as he appears ready to negotiate.

Tobin, R-Paulden, who opposes the Brewer plan as drafted, said he is working on an alternative that could include putting a time limit on the broadened eligibility and the hospital tax that helps fund it, stronger legislative oversight of the state's Medicaid program and audits of hospital finances.

The speaker's comments came as Brewer hit the pause button on legislation, saying she won't sign any more bills until lawmakers get moving on a new budget and Medicaid expansion.

"The governor simply believes that it's time for the Legislature to really get down to brass tacks with the budget and Medicaid," Brewer spokesman Matthew Benson said Friday. "We are anxiously awaiting further details on Speaker Tobin's proposal."

Brewer has been prodding lawmakers to move on her expansion plan since she released draft language almost two months ago, and she has made clear that she won't sign a fiscal 2014 budget without it. But she has been battling members of her own Republican Party who say Medicaid expansion under the federal health-care overhaul is financially unsustainable and politically toxic.

The speaker's support is pivotal because it would bring along reluctant House Republicans to join Democrats and move a bill to the Senate, where a bipartisan majority favors expansion. Senate President Andy Biggs, R-Gilbert, has vowed to block an expansion bill from coming to the Senate floor, but a majority could force a vote if a bill arrives from the House.

Tobin wouldn't say when, or even if, a Medicaid bill would be ready. But he has become more engaged in talks with House members, pro-expansion lobbyists and the Governor's Office, and says he wants to find a way to protect taxpayers, relieve the uncompensated care burden on hospitals and keep people from losing health insurance.

"I want to make sure if I'm going down the road that I have a decent ball to move, or I won't have one," Tobin said. "I'm trying to be helpful."

The two sides also have reached a near-consensus on estimates of how much it would cost to insure poor Arizonans if they passed up Medicaid expansion and did without the billions of federal dollars that come with it.

Tobin and Biggs floated that plan to Brewer earlier in the session, with the state picking up the tab for thousands of childless adults, but she shot it down.

Rank-and-file lawmakers are becoming restless as work at the Legislature has slowed to a crawl and narrowed to three days a week. In coming days, their daily stipend will be cut in half. Rumors are flying around the Capitol that a Medicaid bill could be unveiled as early as next week.

Brewer, a longtime opponent of the rest of the federal Affordable Care Act, is one of eight Republican governors to support expanding the state-federal insurance program for the poor and disabled to 133 percent of the poverty level, or about $15,300 a year.

Florida Gov. Rick Scott was overrun last week by the GOP-led Legislature, and Ohio Gov. John Kasich remains locked in battle with his. So far, 20 states have agreed to expand Medicaid, 15 have said no and 15 are undecided.

In Arizona, Medicaid expansion would insure an estimated 350,000 people, prevent 60,000 from falling off the state's current insurance program for childless adults, and bring in roughly $1.6 billion in fiscal 2015, the first full year.

Under Brewer's plan, the state's additional expenses would be covered with a tax on hospitals, money the facilities would recoup by seeing more insured patients and spending less on uncompensated care.

A policy decision this massive should not be rushed, Tobin said. In an interview Thursday, he bristled at the notion that he has had months to work through the details and rewrite a bill.

"It's not that I haven't been working on it," Tobin said. "I think I've probably put a lot more time into it than the people who wrote the governor's plan."

Tobin said he spoke with Brewer on Tuesday and understands her desire to see action on the big issues of the session, but he can't move any faster than he is now.

"I'm spending all my waking hours trying to figure out a better way for Arizona," he said. "I can't speed that up (just) because she's not signing any more bills."

Tobin said the governor's draft bill was a "non-starter," as he has said since she unveiled it, but he provided a few more details about what should be included in a Medicaid bill for it to get an airing in the House, mostly posed as questions.

"Is the 'circuit breaker' a strong enough circuit breaker? And what do you do to make it stronger?"

Brewer's plan includes a so-called circuit breaker, a provision to roll back coverage for those between 100 percent and 133 percent of the poverty level if federal funding falls below 80percent of the expansion cost.

"Do you say this thing is all going away at a certain time? … Do you want something that goes on forever?"

That calls for a sunset review, which other lawmakers have suggested could come after three years, to reassess the program.

"How do we know that the hospitals won't continue to shift" costs for uncompensated care to privately insured patients?

Hospitals have seen their uncompensated care costs soar since Brewer and lawmakers capped the Arizona Health Care Cost Containment System's program for childless adults. More than 150,000 people have fallen off AHCCCS rolls since then, and an unknown number have been frozen out.

Brewer and expansion supporters, led by the health-care industry, the Arizona Chamber of Commerce and the AARP, say those with insurance are paying a "hidden health-care tax" because the costs of treating the uninsured are passed on to them in higher hospital rates and insurance premiums.

Tobin and other expansion skeptics want to make sure hospitals don't continue to pass along those costs to paying customers if more people become insured under Medicaid and hospitals' financial strain is eased.

That could mean a law that gives the Legislature a look into hospital finances.

They also want to curb AHCCCS authority to set the tax rate on hospitals to raise funds for expansion.

And although Biggs and Brewer have said they don't support sending the measure to the ballot for voters to decide, Tobin said he would not rule that out if negotiations failed.

"I don't take any options off the table on any of these big issues," he said. "I don't know why anyone else would. If the goal is, how do we get from Point A to Point B, then nothing should be off the table."

Republic reporter Mary Jo Pitzl contributed to this article.

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Obama Must Walk Fine Line as Congress Takes Up Agenda

WASHINGTON — The days ahead could be decisive ones for the main pieces of President Obama’s second-term agenda: long-range deficit reduction, gun safety and changes to immigration law.

With Congress back this week from a recess, bipartisan groups of senators who have been negotiating about immigration and gun violence are due to unveil their agreements, though prospects for a gun deal are in question as the emotional impact of the massacre in Newtown, Conn., has faded and the National Rifle Association has marshaled opposition. And on Wednesday, Mr. Obama will send his annual budget to Capitol Hill intended as a compromise offer, though early signs suggest that Republican leaders have little interest in reviving talks.

Members of both parties say Mr. Obama faces a conundrum with his legislative approach to a deeply polarized Congress. In the past, when he has stayed aloof from legislative action, Republicans and others have accused him of a lack of leadership; when he has gotten involved, they have complained that they could not support any bill so closely identified with Mr. Obama without risking the contempt of conservative voters.

Representative Chris Van Hollen, Democrat of Maryland, called this predicament Mr. Obama’s “Catch-22.” And Senator Mark Warner, Democrat of Virginia, said he had often seen it at work since 2010 while negotiating with Republican lawmakers to reach a long-term budget agreement.

At times, Mr. Warner said, Republicans would urge him to get Mr. Obama more involved, saying, “Gosh, Warner, we’ve got to have the president.” Other times, he said, the same lawmakers would plead otherwise, saying, “If the president comes out for this, you know it is going to kill us in the House.”

“Everybody wants him involved to the right degree at the right moment,” Mr. Warner said, “but not anytime before or after.”

The challenge for Mr. Obama became evident as soon as he took office, when Republicans almost unanimously opposed his economic stimulus package even as the recession was erasing nearly 800,000 jobs a month. The author Robert Draper opened his recent book about the House, “Do Not Ask What Good We Do,” with an account from Republican leaders who dined together on the night of Mr. Obama’s 2009 inauguration and agreed that the way to regain power was to oppose whatever he proposed.

Though Mr. Obama was able to prevail over Republican opposition in his first two years as president because Democrats had majorities in the House and the Senate, that changed when Republicans won control of the House in 2010, giving them a brake to apply to the president’s agenda.

Other than the stimulus experience in early 2009, the moment that most captured that polarization for the White House occurred a year later. In early 2010 Republican senators, including the minority leader, Senator Mitch McConnell of Kentucky, demanded that Mr. Obama endorse bipartisan legislation to create a deficit-reduction commission. But when he finally did so, they voted against the bill, killing it.

Now the president’s three pending priorities are shaping up as test cases for how he and Republicans will work together — or not — in his second term.

Each measure — on the budget, guns and immigration — in its own way illustrates the fine line that Mr. Obama must walk to succeed even with national opinion on his side. Privately, the White House is optimistic only about the prospects for an immigration bill, which would create a path to citizenship for about 11 million people in the country illegally.

That is because an immigration compromise is the only one that Republicans see as being in their own interests, given their party’s unpopularity with the fast-growing Latino electorate. In contrast, most Republicans see little advantage in backing gun legislation, given hostility toward it in their states or in districts throughout the South and the West and in rural areas. A budget compromise would require agreeing to higher taxes, which are anathema to conservative voters, in exchange for Mr. Obama’s support for the reductions in Medicare and Social Security that they want.

Yet even on immigration, many Republicans are weighing their party’s long-term interests in supporting a compromise against their own short-term arguments for opposing one: antipathy remains deep in conservative districts to any proposal that would grant citizenship. That calculation also holds for Republicans planning to seek the 2016 presidential nomination.

Against this backdrop, Mr. Obama early on outlined elements that he wanted in the immigration and gun measures. Then he purposely left the drafting to Congress. Senior aides, mainly the chief of staff, Denis R. McDonough, and the deputy chief of staff, Rob Nabors, check in daily with senators. Vice President Joseph R. Biden Jr. stays in touch with his former Senate colleagues about the gun bill talks.

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Kielsky takes on Montgomery

In the race for Maricopa County attorney, a heavily favored Republican incumbent is being challenged by a Libertarian who has run twice before for the office.

County Attorney Bill Montgomery, who took office after winning a special election in 2010, is facing Libertarian opponent Michael Kielsky. The Democratic Party did not slate a candidate in the race.

One of the sharpest contrasts between Montgomery and Kielsky is views on enforcing laws. Montgomery presents himself as a law-and-order stalwart who, in his career as a prosecutor, has pursued tough sentences. Kielsky's main campaign promise is that he will not prosecute victimless crimes such as marijuana possession and prostitution, using the slogan, "No victim, no crime, no time, no fine!"

Montgomery, 45, has done no television campaigning and bought no print ads. He and Kielsky will participate in a lunch forum tentatively set for Monday at the Phoenix School of Law.

Kielsky, 48, says, "It will be my most successful run yet" because the voters of Maricopa County will express their dissatisfaction with Montgomery's first two years as county attorney.

The last general election for Maricopa County attorney, in 2008, was a horse race in which then-incumbent Andrew Thomas edged out Democrat Tim Nelson.

But less than two years later, the Maricopa County Attorney's Office was thrown into turmoil because of Thomas' skirmishes with judges and county officials. Thomas resigned to run for Arizona attorney general.

Former County Attorney Rick Romley battled against Montgomery to replace Thomas, but Montgomery, the party's preferred candidate in the Republican primary, won and then rolled over Kielsky in the November 2010 special election.

Montgomery's tenure has been relatively uneventful compared with Thomas'; he has presented himself as a conservative lawman in contrast to Thomas' anti-corruption crusader. Montgomery has gotten criticism from political pundits for not pressing criminal charges against politicians who allegedly took favors from the Fiesta Bowl or against Arizona Attorney General Tom Horne for possible campaign-finance violations. Horne defeated Thomas in the 2010 GOP primary for attorney general.

Montgomery said that there was insufficient evidence to warrant criminal charges and that seeking indictments "opens me up to criticism that there was a political reason to get an indictment."

Tempe-based polling expert Michael O'Neil said he thinks a Democratic opponent could have capitalized to some degree on the lack of prosecutions.

"You could say he's protecting his cronies and build a campaign on that," O'Neil said. But "nobody is willing to step up for a race that they would definitely lose."

Montgomery moved to improve relations with county managers and the county Board of Supervisors, and his press conferences often focus on community activities such as shred-a-thons to combat ID theft or anti-drug programs.

On broader political issues, Montgomery has hewed to Republican Party positions, such as supporting Senate Bill 1070, the embattled Arizona immigration law. In addition, he will defend the state's ban on abortions beyond 20 weeks of pregnancy before the 9th U.S. Circuit Court of Appeals next month.

He has been outspoken against Proposition 121, which would create an open primary system instead of separate primaries for each political party. He also has opposed the successful citizens' initiative that allows for legal medical use of marijuana. Kielsky supports decriminalization of marijuana.

Kielsky, a former head of the Arizona Libertarian Party, ran for a seat on the board of the Central Arizona Water Conservation District in 1992. He then ran for justice of the peace in 2002, Congress in 2004 and county attorney in 2008 and 2010.

As in his past campaigns, Kielsky, who has been an attorney since 2006, does not take stands on major political issues, instead focusing on not wasting resources by prosecuting victimless crimes, saying this will save money, lower the prison population and provide greater freedom and justice. He said he would not devote resources to prosecuting minor drug-possession charges, prostitution or immigration offenses.

"The job of the county attorney is to help protect individual rights by prosecuting those who harm other people," he said. "Bill Montgomery, like his predecessor, is spending a lot of resources on prosecuting people who aren't hurting anyone."

"How about if we just focus on the core issues of that office?" he said.

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Romney Takes Liberties With Claims About a Bipartisan Past

When Mitt Romney accused President Obama in their debate Wednesday night of refusing to work with Republicans, he held up his own record as the Massachusetts governor as an example of what political cooperation can achieve.

As a Republican governor whose legislature was 87 percent Democrats, he said, “I figured out from Day 1 I had to get along, and I had to work across the aisle to get anything done.” The result, he said, was that “we drove our schools to be No. 1 in the nation. We cut taxes 19 times.”

Mr. Romney and the legislature did at times get along, Massachusetts schools were often top-rated, and some taxes did drop during Mr. Romney’s four years as governor, from 2003 through 2006. But a comparison of his claims to the factual record suggests that all three take liberties with the truth.

While the governor and the legislature came together to produce balanced budgets and enact a signature health care reform bill, much of those four years were characterized by conflict and tensions. In the opening months of his tenure, Mr. Romney vetoed a Massachusetts House plan to create new committees and raise staff members’ pay, and the legislators rejected his flagship proposal, a nearly 600-page plan to overhaul the state bureaucracy.

Mr. Romney proved to have a taste for vetoes, killing legislative initiatives in his first two years at more than twice the rate of his more popular Republican predecessor, William F. Weld, The Boston Globe reported in 2004. The lawmakers responded in kind by overriding his vetoes at a rapid pace.

By 2004, the second year of his term, Mr. Romney was provoked enough to mount an unprecedented campaign to unseat Democratic legislators, spending $3 million in Republican party money and hiring a nationally known political strategist, Michael Murphy.

The effort failed spectacularly. Republicans lost seats, leaving them with their smallest legislative delegation since 1867. Democratic legislators were reported at the time to have been deeply angered by the campaign’s tactics.

“They had a deteriorating relationship during the first two years,” Jeffrey Berry, a political science professor and expert on state politics at Tufts University, said in an interview. The campaign “was designed to demonstrate that he could make life difficult for them if he chose to do so. It did not endear him to them.”

Mr. Romney quickly initiated a charm offensive, inviting Democratic leaders to dinners at his home for the first time since taking office two years earlier. But the legislators were soon “infuriated,” Mr. Berry said, when Mr. Romney, testing the presidential waters, began traveling outside the state and casting brickbats at Massachusetts’s traditionally liberal values before crowds of potential supporters.

On education, Mr. Romney was factually correct in stating that Massachusetts students were ranked first in the nation during his tenure. Massachusetts students in grades four and eight took top honors or tied for first in reading and mathematics on the 2003 National Assessment of Educational Progress, a federal Department of Education test often called the nation’s report card.

However, educators largely agree that the state’s rise to first place was a result of a wholesale reform of state schools enacted 10 years earlier under Governor Weld. The reforms, carried out over eight years, doubled state spending on schools and brought standards and accountability to both administrators and students.

“Governor Romney does not get to take the credit for achieving that No. 1 ranking,” said Mike Gilbert, the field director for the nonprofit Massachusetts Association of School Committees, “but it did happen while he was in office.”

Under Mr. Romney, neither the governor nor the legislature enjoyed notable successes in education, although Mr. Romney is credited with battling successfully against efforts to dismantle some of the 1993 reforms.

Mr. Romney and the legislature cut deeply into state grants to local governments in 2003 amid a state budget crisis, forcing many school districts to raise property taxes. In 2006, Mr Romney vetoed a bill passed unanimously by the legislature that established standards for preschool education and set long-term plans to make it universal. He said the programs would cost too much at a time of budget austerity.

Mr. Romney’s claim that he was responsible for 19 separate tax cuts is also technically accurate. But here, too, the complete story paints a very different picture.

Perhaps the most substantial tax reduction occurred in 2005, when Mr. Romney’s administration wrote legislation refunding $250 million in capital gains taxes to 145,000 investors. But the legislation carried out a court ruling finding that the taxes had been illegally withheld in 2002; the court gave the state the option of refunding the taxes or rewriting the law to correct the illegality.

Mr Romney proposed the latter, and the legislature agreed.

Of the remaining 18 tax cuts, many were proposed by the legislature, not Mr. Romney, and others were routine extensions of existing tax reductions that were due to expire. One was a change in the Massachusetts tax code to make it conform to changes in the federal code. Two were one-day sales-tax holidays.

Mr. Romney’s critics note that his administration was also responsible for revenue-raising measures which, under that loose definition, might well be called tax increases. In his first year, Mr. Romney closed business tax loopholes and increased fees on an array of services, from marriage licenses to home purchases.

“Our numbers on revenue are that he raised about $750 million annually — $375 million from fees and $375 million from corporate taxes,” said Michael Widmer, president of the nonpartisan Massachusetts Taxpayers Foundation.

In 2004, Mr. Romney signed legislation allowing local officials to collect an additional $100 million in commercial property taxes from businesses.

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Column: Obama takes aim at Romney

Cal Thomas is a conservative columnist. Bob Beckel is a liberal Democratic strategist. But as longtime friends, they can often find common ground on issues that lawmakers in Washington cannot.

By H. Darr Beiser,, USA TODAY

Head of the Democratic National Committee: Rep. Debbie Wasserman Schultz of Florida tests the podium Tuesday in Charlotte, in preparation for the first day of the party's convention.

By H. Darr Beiser,, USA TODAY

Head of the Democratic National Committee: Rep. Debbie Wasserman Schultz of Florida tests the podium Tuesday in Charlotte, in preparation for the first day of the party's convention.

Today:Obama takes the stage

Bob: Gallup reports that Mitt Romney had the smallest polling increase from any presidential convention since 1984. Romney's address to the GOP convention in Tampa, according to Gallup, was the least well-received speech since Bob Dole in 1996. Romney wanted this election to be a referendum on Barack Obama, but because Romney failed to close the sale on his own candidacy, he's given Obama an opening to make Romney an issue.

Cal: Nice try at those DNC talking points, Bob. Here in North Carolina, where I am spending the week with your political brethren, the new Elon University/Charlotte Observer Poll shows Romney leading President Obama 47% to 43% in the state. But enough about polls. Last week, we agreed on what Romney needed to say to the GOP convention and those watching on TV. Now, what do you think the president should say in his speech tonight?

Bob: In his acceptance speech, Romney did not harshly attack the president, which I thought was a good strategy. He let others, including Paul Ryan, do his dirty work for him. Speaker after speaker at the Democratic convention has attacked Romney for proposing warmed over policies from "the last century" and his running mate as radical and dangerous. Obama should do something similar, and to the extent he mentions Romney, it should be to compare the president's policies, popular or not, with Romney's lack of a single new idea.

Cal: The "last century" with its economic booms and defeat of communism in Russia and fascism in Germany is looking better all the time. I agree the president has a record. I anticipate the "failure" of the Democratic convention will be that Democrats will offer more of the same failed solutions. The president made some spectacular promises four years ago, few of which he has kept. It's going to be very difficult to defend that record, given the high expectations he generated, especially on unemployment, which he pledged the stimulus would hold to under 8%. Even Maryland Democratic Gov. Martin O'Malley admitted to Bob Schieffer last Sunday on CBS's Face the Nation that America is no better off today than it was four years ago.

Bob: My cardinal rule in politics is to effectively manage expectations. The goal of any campaign should be to keep expectations in the right place so the candidate's strengths can exceed expectations and in the process minimize his weaknesses. If any president has ever suffered from high expectations, it's Barack Obama.

Cal: That was not the Republicans' fault. He almost single-handedly created those expectations with all of that lowering of the oceans business and other messianic talk.

Columns

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Roughly half of our columns come from our Board of Contributors, a group whose interests range from education to religion to sports to the economy. Their charge is to chronicle American culture by telling the stories, large and small, that collectively make us what we are.

We also publish weekly columns by Al Neuharth, USA TODAY's founder, and DeWayne Wickham, who writes primarily on matters of race but on other subjects as well. That leaves plenty of room for other views from across the nation by well-known and lesser-known names alike.

Bob: I agree. Obama has himself to blame after raising expectations during his extraordinarily effective campaign in 2008. He made promises that were nearly impossible to fulfill, particularly about changing the tone in Washington. He did not expect to be facing a Republican Party that had moved radically to the right and had no interest in working with President Obama.

Cal: Whatever happened to the Democratic Leadership Council, which Bill Clinton headed? These were moderate Democrats who were willing to compromise to move the ball forward. Look at the convention lineup of speakers. There isn't a pro-life, smaller-government, lower-taxes, less-spending, traditional-marriage speaker among the lot. The Democratic Party is now ruled exclusively by the hard left, and yet there are many Democrats who favor some, or all, of these moderate-to-conservative issues. Do you think the president in his speech tonight will have anything to say to these Democrats?

Bob: The DLC was a Clinton-driven organization that left the scene when he did. If you like radical speakers, Tampa was full of them last week. Back to the president's speech. I think Obama must address the expectations issue, and I know some people around him agree. As he told a CBS reporter, he failed "to tell a story to the American people that gives them a sense of unity and purpose and optimism."

Cal: It's a little late for that, don't you think?

Bob: No, I don't. For all his formidable skills as a campaigner and orator, Obama failed to tell the country why he was embarking on new directions in health care and why his stimulus package was necessary. He never sought to downplay the expectations of 2008 when he knew full well that they could not be met. Therefore, I think Obama needs to do a bit of mea culpa in his speech to let the voters know that he knows he hasn't met all their expectations, but that he is making every effort to do so.

Cal: A mea culpa doesn't fit his personality and will seem disingenuous. It would be like Madonna suddenly advocating modest dress. The public is cynical enough about politicians in both parties. The late comedian George Burns is supposed to have said, "Sincerity is everything. If you can fake that, you've got it made." Given the public's growing distrust of government, it is increasingly difficult to "fake sincerity." You've been a strategist. Should he attack Romney, or ignore him?

Bob: As I've mentioned, a little of both. When Obama talks about Romney, he should avoid talking about Bain Capital and Romney's refusal to release more of his tax returns. Those issues have been covered in his advertising and by others. Rather, Obama should point out that Romney is quick to raise all the problems facing America and has yet to offer solutions to solve them.

Cal: That's a fair point. As for Bain, Deroy Murdock wrote last week in the New York Post, "Bain's private-equity executives have enriched dozens of organizations and millions of individuals in the Democratic base — including some who scream most loudly for President Obama's re-election." So lay off Bain, Mr. President, and tell us if we're in for more of the same policies if you are re-elected.

Bob: Speaking of policies, even TheWall Street Journal panned Romney's speech because he offered no new policies beyond cutting taxes, increasing defense and, in a break with his running mate, Romney said he will protect Social Security and Medicare. This adds up to massive deficits and perhaps taxes on the middle class. It's no wonder so many economists laugh at Romney's warmed over trickle-down policies.

Cal: With the national debt climbing past $16 trillion, I'm glad you are suddenly concerned with debt, which is caused by overspending, not under-taxing. More and more voters don't trust either party to do what it says, but I think they'll give Republicans one more chance to rescue us from this financial sinking ship. If they fail, as we have written in a previous column, voters will keep tossing out incumbents until they get leaders who will do the necessary things to repair the economy.

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Obama Campaign Takes Gamble in Going Negative

With 100 days remaining before Election Day, there is an air of apprehension around the Obama campaign headquarters here. Yet there are few regrets about the tone of the race, only a conviction that the circumstances — a frail economy, intense Republican opposition and a well-financed negative campaign from Mr. Romney and his allies — left Mr. Obama no option but to fight back even if it sullies his image as a candidate of hope and change.

“Is it a different kind of race than 2008? Of course,” said David Axelrod, a senior campaign strategist. “If we were passive in the face of this onslaught we are facing, our folks would be unhappy. There are few on our side who are counseling us to sit idly by.”

Mr. Romney and his allies are giving as good as they get, lacerating Mr. Obama as hapless in promoting job creation, feckless with allies like Israel and determined to expand government until the United States resembles Sweden.

As the campaigns prepare for the next phase of the race, the two sides are taking stock of what they have achieved in their first sustained engagement, a relentlessly negative effort over the last two months to define the other. The exchanges have been so fierce that hardly a positive ad has been broadcast in July.

But both the opportunities and the risks in the definition wars are greater for Mr. Obama. Mr. Romney is less well known to the public, giving Democrats a chance to shape perceptions of him just as more voters are starting to tune in to the race.

The president’s prospects for re-election now rest in part on one of the biggest gambles of his career: that the benefits of trying to eviscerate Mr. Romney outweigh the costs to his own image and reputation.

With a political climate ripe for unseating an incumbent, the president’s campaign team signaled long ago that it had no intention of trying to replicate the 2008 race, and made it clear last year that if Mr. Romney won the Republican nomination, they would rush to aggressively define him before turning to a forward-looking message in the fall.

Mr. Obama, whose competitive and confident streaks seem to have been rekindled by the challenge from Mr. Romney, has shown no inclination to hold back in trying to portray his rival as a secretive Bush-era throwback whose wealth puts him out of touch with the middle class.

The president not only approves of his television ads, as federal election law requires him to say in each commercial, he also screens many of them in advance, either on his iPad or during a regular Sunday evening meeting with political advisers at the White House.

Fearful of the tone becoming too shrill, he took the rare step of speaking directly to the camera in a new ad that elevates the conversation, a hint of his approach when the campaign moves beyond summer.

“Sometimes politics can seem very small,” Mr. Obama said, sounding almost apologetic. “But the choice you face, it couldn’t be bigger.”

His aides wondered in particular whether a recent spot showing Mr. Romney singing “America the Beautiful,” while headlines about outsourcing and overseas bank accounts flashed, was too negative. The president and some of his strategists were unsure, aides said, but a focus group of voters found it to be fair. They still tested the ad again before showing it.

The ratio of negative ads, which are defined as those in which a campaign mentions its rival by name, tells the story. Since April, after Mr. Romney became the presumptive nominee, Mr. Obama broadcast negative commercials 118,775 times compared with 56,128 times for positive commercials.

In the same time period, Mr. Romney ran negative spots 51,973 times and positive spots 11,921, according to an analysis from Kantar Media, which tracks political advertising. This does not include the Republican “super PAC” ads that are almost entirely attacks on the president.

“President Obama was keeping a more balanced mix, but by the end of June he turned off the positive spigot,” said Elizabeth Wilner, who studies advertising for the group.

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New Republican Ad Takes a Soft Shot at Obama

When it makes its debut Wednesday in 10 swing states as the centerpiece of a $25 million campaign, it is expected to become one of the most heavily broadcast political commercials of this phase of the general election.

Yet what Mr. McCarthy and Crossroads have produced is not the kind of searing denunciation of President Obama that their track records would suggest. More soft-pedal than Swift Boat, the 60-second advertisement, complete with special effects, is a deeply researched, delicately worded story of a struggling family; its relatively low-key tone is all the more striking, coming at a point in the campaign when each side is accusing the other of excessive negativity.

Behind the story of the ad’s creation rests one of the greatest challenges for Republicans in this election: how to develop a powerful line of attack against a president who remains well liked even by people who are considering voting against him.

The concept for the newest advertisement and even some of the lines in the script were culled directly from focus groups of undecided and sometimes torn voters that were held over nearly a year. As Crossroads strategists would learn after 18 different focus groups and field tests, from Missouri to Colorado to Ohio to Florida, the harshest anti-Obama jabs backfire with many Americans.

Middle-of-the-road voters who said they thought the country was on the wrong track were unmoved when they heard arguments that the president lacks integrity. And they did not buy assertions that he is a rabid partisan with a radical liberal agenda that is wrecking America.

“They are not interested in being told they made a horrible mistake,” said Steven J. Law, president of Crossroads GPS and the affiliated “super PAC,” American Crossroads. “The disappointment they’re now experiencing has to be handled carefully.”

In interviews with voters, Crossroads strategists picked up on some common sentiments that they concluded could provide a clear rationale for voters to deny Mr. Obama a second term.

Some said they felt that the president was an eloquent communicator, but that his actions had failed to live up to his words. They said they thought the country’s budget problems had gotten out of hand, yet the government kept spending recklessly — like someone with maxed-out credit cards. And they reported being worried that their children would not have the same opportunities to get ahead as they had.

All these thoughts made their way into Mr. McCarthy’s script. But one exchange in particular, at a focus group in St. Louis in October, gave Mr. McCarthy and Mr. Law the idea for the ad, which they named, innocuously enough, “Basketball.”

A woman described how her 32-year-old son, burdened by student loans and unable to make ends meet, had moved back home. “That particular group had several women who basically told the same story,” Mr. McCarthy said.

The script, which he started writing that day in October, features a composite character from the focus groups. “Kind of like President Obama’s girlfriends,” he noted dryly, referring to Mr. Obama’s acknowledgment that a girlfriend he referred to in his book “Dreams From My Father” was a composite of several women he knew.

The ad opens with a woman talking about her family’s financial woes. “I always loved watching the kids play basketball,” the actress says, her voice heavy with worry as she glances out at her backyard. “I still do, even though things have changed.”

Her face quickly morphs into an old woman’s. Her skin is wrinkled, her hair gray. She explains how her adult children have moved back into the house because they are unable to find jobs. And she is not sure she can afford to retire now.

“I supported President Obama because he spoke so beautifully,” she says. “He promised change. But things changed for the worse.”

Ben LaBolt, a spokesman for the Obama campaign, dismissed the commercial’s premise. “However many millions Mitt Romney’s special interest allies spend won’t change the facts,” he said, noting that the economy has strengthened considerably since 2008.

In previous presidential campaigns, Republicans have relished mocking their Democratic opponents. They made commercials with video of Michael S. Dukakis riding in a tank wearing an oversize helmet, leaving viewers with images that many thought made him look silly and unpresidential.

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