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GREENSBORO, N.C. – As Hillary Clinton focused on Bernie Sanders in Michigan on Monday, the day before the primary there, her husband, former President Bill Clinton, had some tough words for Mr. Sanders in North Carolina, where early voting is underway for the March 15 nominating contest.

If Mr. Clinton’s line of attack was familiar – that Mr. Sanders dismisses all critics as being part of “the establishment” – the former president added some sharp language at a small rally here at Elon University law school. He argued that Mr. Sanders was ducking arguments over his health care plan and other domestic proposals, then kicked his speech up a notch as he accused Mr. Sanders of resorting to name-calling with his tirades against the “establishment.”

“That’s killing America, that kind of politics,” Mr. Clinton said after describing Mr. Sanders’s rejection of skeptical reports by liberal economists on his Medicare-for-all plan. “That’s what the Republicans do all the time – they just call each other names. Let’s have a conversation.”

Michael Briggs, a spokesman for Mr. Sanders, said in a statement on Monday night that the campaign “has been all about big ideas and specific proposals on how to change our rigged economy and corrupt political system,” and that Mr. Sanders “has a specific ideas that are resonating with grassroots supporters who have made a record 5 million donations to his campaign.”

He added: “He won three of the four states that held contests last weekend and is in this race to the convention in Philadelphia. It looks like President Clinton is understandably nervous about all that and it’s causing him to say some things that don’t make sense.”

Mr. Sanders has at times responded to critics – usually Clinton allies – by calling them part of the political establishment, but he and his campaign have also put out details about higher taxes and potential savings associated with his heath care and he has defended the substance of it.

While Mrs. Clinton is far ahead of Mr. Sanders in their race for delegates needed to win the nomination, and she leads in public polls in North Carolina, the Clinton campaign has remained on the offensive against Mr. Sanders, the Vermont senator, criticizing his policy record and questioning his openness to criticism.

Mr. Clinton was also blunt in assailing Republicans who have rejected Medicaid money to provide health care for more people under the Affordable Care Act. Mr. Clinton said some Republicans had used “coded racist language” when they criticize Medicaid dollars as a kind of “welfare.”