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Sen. Hillary Clinton Unveils $110 Billion Universal Health Care Plan

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.

Clinton's plan is comprised of four main pillars:

— Offering new coverage choices for the insured and uninsured and guaranteeing quality coverage;

— Lowering premiums by removing hidden taxes, stressing prevention and increasing security by ensuring that job loss or family illness won't lead to a loss of coverage;

— Promoting shared responsibility among individuals, providers, employers and government, and forcing insurance and drug companies to end discrimination based on pre-existing conditions and price gauging; and

— Ensuring affordable health coverage for all by providing tax relief, limiting premium payments to a percentage of income and strengthening Medicaid.

Click here to read more about Hillary Clinton's proposal in Update '08.

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 opponents were quick to meet her expectations. A spokeswoman for Rudy Giuliani called the plan "HillaryCare 2.0."

"Clinton’s latest health scheme includes more government mandates, expensive federal subsidies and more big bureaucracy – in short, a prescription for an increase in wait times, a decrease in patient care and tax hikes to pay for it all,” Giuliani spokeswoman Katie Levinson said.

"Hillary care continues to be bad medicine," said Republican Mitt Romney, who introduced universal health care while governor of Massachusetts "It's government in Washington, as opposed to states. It's government plans opposed to private plans. It's raising taxes as opposed to holding taxes level. It's not the right course to solving our health care problems."

The Massachusetts plan requires the same individual insurance mandate as Clinton's and uses state subsidies to help reduce the cost of private coverage. Since then, Romney has said he would leave it up to the states to decide whether they supported such a mandate.

Edwards too suggested that Clinton's prior fight has not prepared her for the challenges of today.

“The cost of failure 14 years ago isn’t anybody’s scars or political fortune," he said. "It’s the millions of Americans who have now gone without health care for more than 14 years and the millions more still crushed by the costs."

"My universal health care plan would go further in reducing the punishing cost of health care than any other proposal that's been offered in this campaign," said Obama.

He also took a swipe at the Clinton administration's closed-door sessions on health care in the 1990s, saying "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."

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.