Hours before they face off in a Democratic presidential primary debate, Sen. Bernard Sanders on Sunday accused Hillary Rodham Clinton of “sounding like a Republican” by attacking his Medicare-for-all plan.

Mr. Sanders, who now leads Mrs. Clinton in some Iowa and New Hampshire polls, said he’s disappointed his primary foe hasn’t come out in favor of a health care plan that would guarantee coverage for every single American. He said the Clinton campaign’s argument that his plan will raise health care costs for average Americans is wrong.

“Sometimes where the discussion becomes really absurd is that we will increase Medicare premiums, that is true. But we are doing away with all private health insurance premiums. And sometimes — and it disappoints me that the Clinton camp is kind of sounding like a Republican,” he said on ABC’s “This Week.” “The truth of the matter is, A) we spend far more per person on health care than any other nation. And second of all, a Medicare for all, single-payer program, would substantially, thousands of dollars a year, lower the cost of health insurance for the middle class of this country. So to say ‘Yes, there will be Medicare premiums,’ yes, of course there will. It’s not free. But we are doing away with all private health insurance costs.”

The spat comes as Mr. Sanders is under fire for his universal health care proposal, which the Clinton campaign says will require tax increases on middle-class families. Mr. Sanders has denied that charge and has said he will release the details of how he would pay for his plan before the Iowa caucuses on Feb. 1.

But Mrs. Clinton has latched on to the issue and has said that, under a Sanders presidency, the Affordable Care Act — President Obama’s signature domestic achievement — would be undone.

“Well, first, I share the goal of universal health care … But I think we should be defending the Affordable Care Act. This is a historic achievement for our country. It certainly is for President Obama. We are making progress. I want us to protect it, to defend it, and to improve it,” she said on “This Week.” “The Republicans keep trying to repeal it and offer nothing in place of it. So rather than tear it apart or get rid of it and start over again in a contentious national debate, let’s do what I’m proposing, to get costs down, get out-of-pocket costs down, get more support for families who face big medical costs.”

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