(CNN) - Mitt Romney's campaign and the Republican National Committee aligned President Barack Obama with House Democratic Leader Nancy Pelosi in a new television ad Tuesday, one day before the year's first presidential debate.
"Who will raise taxes on the middle class? Barack Obama and the liberals already have," the ad's narrator says, as the video pauses on a photo of Obama and Pelosi smiling for a camera.
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It's the second time in two weeks the Romney campaign has made an ad targeting Obama's connection to the House minority leader, who remains a frequent target for Republicans.
The 30-second spot, "Already Has," also attacks the duo on the health care reform bill that passed in 2010 while Pelosi served as House speaker. She lost that position later in the year when Republicans retook the House majority.
Romney's campaign and surrogates frequently criticize Obama for accomplishing little in reducing the deficit during the first two years of his term, when Democrats had control of both chambers of Congress.
"Mitt Romney and common-sense conservatives will cut taxes on the middle class. And they'll close loopholes for millionaires," the narrator says. "Obama and his liberal allies? We can't afford four more years."
Last Sunday, the campaign released a commercial based on an excerpt from a new book by longtime reporter and editor Bob Woodward.
The account details a moment when Pelosi snubbed the president during the heated 2011 debt deal showdown. The former House speaker has strongly denied the story.
While the ad chides Obama's ties to Democratic leaders on Capitol Hill, several high-profile Republican Congressional leaders hit the trail for Romney on Tuesday, perhaps as a point of contrast.
Current House Speaker John Boehner campaigns for the GOP nominee in Florida, while Sen. Marco Rubio appears in Las Vegas, not far from the site of Obama's debate preparation.
Also Tuesday, Sen. John McCain kicks off a bus tour in Florida for Romney.
Tuesday's ad also features Romney standing with Sen. Rob Portman of Ohio and Sen. Kelly Ayotte of New Hampshire, two top Senate surrogates for the former Massachusetts governor.
Romney's campaign did not say where the new commercial will air or give details on the amount of the ad buy.
Asked about the ad in a press conference later Tuesday, Pelosi said the use of her image in a Romney commercial–now for the second time–shows a lack of creativity.
"I think it demonstrates a poverty of their own ideas," Pelosi responded, referring to the GOP nominee's campaign.
She added, "Elections are about what are you going to do to make my future better, and I think it's an act of desperation on their part."
Obama's re-election campaign also took issue with the ad, saying Romney's claim that the president raised taxes is "false."
Campaign spokeswoman Lis Smith pointed to an event last week in Ohio, where Romney, himself, acknowledged Obama did not raise taxes during his first term.
"I admit this, he has one thing he did not do in his first four years – he's said he's going to do in the next four years – which is to raise taxes," Romney said on Sept. 25.
Smith, however, argued Romney would be the one raising taxes on middle income earners.
"Romney's proposing a $5 trillion tax cut skewed toward millionaires and billionaires that would require him to raise taxes on middle class families by cutting deductions they rely on," Smith said in a statement. "That's why he's not telling the truth – his plan would slow our recovery and punish the middle class."
– CNN Senior Congressional Producer Deirdre Walsh contributed to this report.