Hillary Clinton's new plan to provide health care for all Americans differs more from her 1993 proposal known as "Hillarycare'' than it does from ideas offered by her chief Democratic rivals in the 2008 presidential campaign.

Clinton's proposal, presented yesterday in Iowa, draws on the same four principles that opponents Barack Obama and John Edwards already put on the table: Allowing many Americans the option of paying to join a new government-run plan, requiring insurance companies to accept all applicants and not charge more for those who are ill, giving subsidies to help families afford coverage and raising taxes on upper-income Americans to pay for it all.

"The big message is how similar the plans are,'' said Len Nichols, who worked on health-care issues for President Bill Clinton and is now director of the Washington-based New America Foundation's health program. "These are very smart people who are very ambitious, and they are ending up with very much the same rough contours...''

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