DES MOINES, Iowa – Hillary Rodham Clinton and Barack Obama intensified the bickering Sunday over their competing health plans, reflecting the crucial stakes as Iowa's leadoff caucuses in early January approach.
Clinton said Obama's proposal was "crafted for politics" and the latest example of his shifting policy positions. Obama said much the same of her approach.
"Senator Obama and I have been having a debate about health care for a couple of days and it's a very important debate," Clinton said in a telephone interview with The Associated Press. "The difference is my health care plan covers every American and Senator Obama's plan will not."
Obama focused on Clinton's proposal to require that people buy coverage. His approach carries no such mandate, which he says is potentially costly for consumers.
"The reason Americans don't have health insurance isn't because they don't want it, it's because they can't afford it, which is why my plan doesn't have a mandate and goes further in cutting costs than any other proposal offered in this race," Obama said during a campaign stop to discuss health care issues. He said people could save up to $2,500 a year under his plan -- more than any of his rivals.
Clinton disputed that, saying very similar cost savings are built into hers.
"He leaves 15 million people uncovered," the New York senator said. "It's a plan crafted for politics, not for people."
Obama responded: "Hillary's idea is that we should force everyone to buy insurance. But this is yet another issue where she is not being straight with the American people because she refuses to tell us how much she would fine people if they couldn't afford insurance."
The Illinois senator said it is another instance of political maneuvering on Clinton's part. "So unless she can answer those questions this is yet another calculation that's more about getting through an election than actually solving the health care problems," he said.
Obama credited the new criticism from Clinton to his improved poll numbers in Iowa.
"This is politics," Obama said in an interview with The Associated Press. "This is her apparently being concerned about her standing in Iowa."
Obama's aides have suggested the candidate would leave it up to the states to consider imposing a mandate; some of have begun to move in that direction.
"That is unworkable. Can you imagine 50 state bureaucracies, the billions of dollars wasted on redundancy?" Clinton said. "This is an American problem and we need an American solution."
In recent appearances, Obama has revived criticism of Clinton's failed effort to overhaul the health care system in the 1990s when she was first lady. He also has accused her of being too secretive.
"An important part of this effort will be creating an open, transparent process so the American people feel informed about and invested in what we're trying to do," Obama said. "When the American people are paying attention and are brought into the process, there's nothing we can't achieve."
Clinton said Obama tried to convince voters at first that his plan would offer universal coverage, then acknowledged it would not cover everyone and now is trying to justify an approach that falls short of universal coverage. The Obama campaign circulated a memo to reporters Sunday demanding to know how Clinton would enforce the mandate, noting that one state -- Massachusetts -- has taken that route and consumers that do not get coverage lose their personal tax exemption, a $219 cost.
"Now he's trying to justify the fact that he doesn't cover everyone," Clinton said. She said Obama's plan would leave 15 million people relying on expensive emergency room coverage.
The sharp tenor of Clinton's remarks, and her direct engagement of Obama, reflect the tight race in Iowa. Clinton has amassed a big lead in national polls and a win in Iowa could give her would give her an enormous amount of momentum. That leaves her rivals viewing Iowa as the best or only place to derail Clinton's campaign.