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WASHINGTON, Sept. 15 — Senator on Monday will lay out a plan to secure for all Americans while severely limiting the ability of insurers to deny coverage or charge higher premiums to people with chronic illnesses and other medical problems, her aides and advisers say. Clinton’s purpose, they said, is not only to cover the 47 million people who are uninsured but to improve the quality of health care and make insurance more affordable for those who already have it.

The goal of Mrs. Clinton’s plan, to be outlined in a speech in Des Moines, is similar to that of the ill-fated plan that she and President Bill Clinton pushed in 1993 and 1994. But advisers to Mrs. Clinton, a Democrat from New York, said Saturday that she would try to avoid the perception that she was advocating a bureaucratic, big-government solution. That perception, promoted by conservative Republicans and the insurance industry, sank the Clinton plan in 1994. Previewing her speech, Clinton aides said she would assert on Monday that there was a moral imperative to ensure that “every single American has quality affordable health coverage,” just as she contends there is an economic imperative to rein in costs.

Phil Singer, a spokesman for the Clinton campaign, said Saturday that he could not provide details. But aides and advisers who spoke on condition on anonymity said that Mrs. Clinton would propose expanding the Children’s Health Insurance Program as a step toward universal coverage.

She has denounced President Bush’s efforts to restrict eligibility and limit spending on the program. Clinton aides said her plan would preserve a large role for private insurance companies; would promote the use of health information technology and low-cost generic drugs; and would create a public-private institute to evaluate and compare drugs, devices and medical treatments. Aides to Hillary Rodham Clinton say she is pursuing national health-care goals much like the ones she promoted as first lady. Credit Mark J. Terrill/AP Photo Mrs. Clinton will not try to impose an overall limit on national health spending, the aides said. But she is prepared once again to do battle with insurance companies, which she has said “spend tens of billions of dollars a year figuring out how not to cover people” and “how to cherry-pick the healthiest persons, and leave everyone else out in the cold.” Aides to Mrs.

Clinton said her proposal would elaborate several ideas that she has floated this year. They said, for example, that Mrs. Clinton would amplify a comment in March when she declared, “We could require that every insurance company had to insure everybody, with no exclusion for pre-existing conditions.”. On another occasion, she vowed, “As president, I will end the practice of insurance company cherry-picking once and for all by allowing anyone who wants to join a plan to do so, and by prohibiting insurance companies from carving out benefits or charging higher rates to people with health problems.” Karen M. Ignagni, president of America’s Health Insurance Plans, the chief lobby for insurers, said they endorsed the goal of universal coverage. Ignagni said that insurers denied only 3 percent of claims, and that many of those were for experimental procedures that employers did not cover. Advertisement Mary Nell Lehnhard, senior vice president of the Blue Cross and Blue Shield Association, said, “Some of Mrs.

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