DES MOINES, Iowa – Democratic presidential candidate Hillary Clinton on Monday proposed a health care plan that would require every American to have health insurance just like states require drivers to buy auto insurance.
The so-called "individual mandate" — the centerpiece of her "American Health Choices Plan" — would cost the federal government $110 billion a year and would help provide coverage for 47 million Americans without health care coverage. It is similar to a proposal offered by rival John Edwards. Barack Obama's health care plan does not have the same mandate.
"I believe everyone — every man, woman and child — should have quality, affordable health care in America," the New York senator told an audience in Iowa, vowing to accomplish the goal in her first term.
The senator's proposal comes 13 years after her first effort was abandoned, a plan that was unprecedented for a first lady, both in its scope and criticism.
"Perhaps more than anybody else I know just how hard this fight will be," Clinton said, adding that she is awaiting the pile-on from Republican critics.
"I know my Republican opponents will try to equate health care for all Americans with government-run health care. Don't let them fool us again. This is not government-run," she said.
Clinton said she has learned from the 1990s experience, which almost derailed Bill Clinton's presidency and helped put Republicans in control of Congress for years to come. Aides say she has jettisoned the complexity and uncertainty of the last effort in favor of a plan that stresses simplicity, cost control and consumer choice.
Clinton's plan builds on the existing employer-based system of coverage. People who receive insurance through the workplace could continue to do so; businesses, in turn, would be required to offer insurance to employees, or contribute to a government-run pool that would help pay for those not covered. Clinton would also offer a tax subsidy to small businesses to help them afford the cost of providing coverage to their workers.
For individuals and families who are not covered by employers or whose employer-based coverage is inadequate, Clinton would offer expanded versions of two existing government programs: Medicare, and the health insurance plan currently offered to federal employees. Consumers could choose between either government-run program, but aides stress that no new federal bureaucracy would be created under the Clinton plan.
Clinton proposed several specific measures to pay for her plan, including an end to some of the Bush-era tax cuts for people making more than $250,000 per year. Edwards has vowed to completely repeal the tax cuts for high earners to pay for the cost of his plan, estimated at $90 billion-$120 billion per year, while Obama would pay for his plan in part by letting the tax cuts expire in 2010.
FOX News' Aaron Bruns and The Associated Press contributed to this report.