Portsmouth, N.H. — President Barack Obama took direct aim at the vocal opponents who’ve been filling congressional town halls on health care Tuesday, saying despite all the “yelling and the shouting and the noise,” health reform will improve the lives of Americans with and without insurance

Obama said special interests who oppose health reform always "try to scare the heck out of folks, and they'll create boogeymen out there that just aren't real" to prevent change. He even sought to rebut directly one of the most widespread rumors — that the bills in Congress include so-called death panels to decide how much coverage people can receive. 

Obama said critics charge that the government will “basically pull the plug on Grandma, because we’ve decided it’s too expensive to let her live anymore” — and denied there is any such thing in the bills. 

"Where we disagree, let's disagree over things that are real, not these wild misrepresentations that bear no resemblance to what's been proposed,” Obama said. 

It was Obama’s most direct attempt to rebut critics of his health reform plans, and it came at a time when even some health reform supporters fret that critics are gaining momentum. Obama had a friendly audience to test his themes here — an event that stood in sharp contrast to some congressional town halls that have devolved into shouting, like one held just hours before in Pennsylvania by Democratic Sen. Arlen Specter. 

Obama’s crowd of about 1,800 — nearly three-quarters of whom received tickets through the White House website — was so friendly that by the end, Obama was soliciting opponents to speak up. “I don’t want people to think I have a bunch of plants in here,” Obama said.

In the end, he fielded no truly hostile questions — though spent much of the town hall on defense, batting down rumors or charges from critics that his solution would balloon the deficit while denying Americans coverage they need. In fact, Obama zeroed in most on the millions of Americans who already have health insurance, saying reform would improve coverage for the insured. 

“So this is what reform is about, for all the chatter and the yelling and the shouting and the noise, you need to know this, If you don’t have health insurance, you will finally have quality affordable options once we pass reform. If you do have health insurance, we will make sure that no insurance company or government bureaucrat gets between you and the care that you need,” Obama said.

You will not be waiting in any lines. This is not about putting the government in charge of your health insurance,” Obama said. “I don’t think government bureaucrats should be meddling, but I don’t think insurance company bureaucrats should be meddling.”

He outlined three reforms that would affect the 85 percent of Americans who already have insurance: Under any new plan, insurance companies wouldn’t be allowed to deny coverage because of pre-existing conditions, out-of pocket expenses would be capped and sick people would no longer be dropped from their insurance plans.

The shift in focus and rhetoric comes as the health care debate has heated up, with Republicans and Democrats scrambling to dictate the narrative in a campaign style back and forth of competing ads, press releases and tweets. Democratic leadership labeled the sometimes raucous tactics of health care opponents as “un-American” and the White House dusted off an election tactic, unveiling a website to dispel misinformation about health care reform, and firing up grass-roots organizers who were the backbone of the campaign.

To sell health insurance reform, the White House continues to rely on the Obama-as-the-best messenger strategy, first with a press conference last month and then with several town halls and radio addresses in the last weeks. Two more town halls are scheduled for Friday, one in Bozeman, Mont., and the other in Grand Junction, Colo.

At times the town hall meeting felt more like a campaign rally, with supporters shouting "Yes, we can" and sporting pass health care reform now stickers. There were a few dozen protesters outside the venue, but the attendees seemed largely star-struck by Obama.

Obama himself was in good form — unlike his more low-key news conference two weeks ago — taking on Republicans who call him “big-spending Obama” by noting they passed a prescription drug bill that did, in fact, add to the deficit. He also accused the media of distorting his message — saying some news outlets said a White House effort to respond directly to critical emails was something more sinister.

“Suddenly, on some of these news outlets, this is being portrayed as 'Obama collecting an enemies list.’ C’mon guys, here I am trying to be responsible to questions being raised out there,” Obama said.

Initially, Obama wanted health care bills out of both houses by the summer recess, instead, there are multiple bills still pending in both houses, and representatives have been shouted down at town hall discussions across the country during their summer recess.