Democratic presidential contender Hillary Clinton, whose first attempt at a health care overhaul fell flat 13 years ago, unveiled a broad proposal on Monday to require health insurance for all Americans and make it more affordable.
The proposal would mandate coverage for 47 million uninsured Americans but maintain a role for private insurance companies in what she said would be a simplified system with more choices for consumers.
"It is time for us to come together and start living up to our values, to provide quality affordable health care for every single American," the New York senator said in a speech in the early voting state of Iowa.
Clinton is the last of the top Democratic candidates to roll out all of her proposals for an overhaul of the health care system and coverage for uninsured Americans, one of the prime issues in the November 2008 White House race.
Her plan includes individual mandates for coverage of all Americans, similar to the plan by rival John Edwards but not included in Illinois Sen. Barack Obama's proposal.
It also provides tax credits for Americans who cannot afford insurance and small businesses straining to provide it, offers more choices for coverage, ends discrimination based on pre-existing conditions and expands Medicaid and the State Children's Health Insurance Program.
Clinton's advisers said the plan would cost about $110 billion a year, paid for through a combination of cost savings and the expiration of some of President George W. Bush's tax cuts for the most wealthy.
The plan is less dramatic than Clinton's failed 1994 initiative, when her husband Bill Clinton was president. She said she learned from that proposal, which was seen as overly bureaucratic and required employers to provide coverage through tightly regulated health maintenance organizations.
"This is not government run. There will be no more bureaucracy. This plan expands personal choice and increases competition to keep costs down," she said. "These are new times and this is a new plan."
RIVALS QUICKLY CRITICIZE PLAN
But it drew quick criticism from Republicans, who called it more of the same, and from Democratic rivals unimpressed with her claims to have learned from past failures.
"While she talks about the political scars she bears, the personal scars borne by the American people are far greater," said Democratic rival Chris Dodd, a Connecticut senator.
"The mismanagement of the effort in 1993 and 1994 has set back our ability to move toward universal health care immeasurably," he said.
Edwards, a former senator from North Carolina, vowed to submit legislation on his first day in office ending health care coverage for the president and members of Congress in mid-2009 unless a universal health care plan was approved by then.
"Actually bringing change starts with telling the truth, and the truth is the system in Washington has been hijacked for the benefit of corporate profits and the very wealthiest," Edwards said in Chicago.
Republicans called Clinton's proposal another big-government fix to the health care problem.
"If you've seen the report this morning on the latest version of Hillarycare, you'll see that version 2.0 is not like to have any more success than 1.0," former Massachusetts Gov. Mitt Romney told reporters in New York. "Hillarycare continues to be bad medicine."
Clinton leads the Democratic 2008 contenders in national polls, but is embroiled in a tight three-way battle in the key state of Iowa with Obama and Edwards.
Obama commended Clinton's proposal but said his plan would go further by reducing the costs of health care, and said he would be able to develop a political environment that could bring about change.
"The real key to passing any health care reform is the ability to bring people together in an open, transparent process that builds a broad consensus for change," Obama said.
(Additional reporting by Deborah Charles)