WASHINGTON — President Bush ratcheted up his confrontation with Democratic leaders today, laying out what he said is a stark ideological divide between a fiscally prudent, free market-loving GOP president and a Congress that aims to raise taxes and nationalize health care.

His remarks were part of a broader effort to seize the offensive against the Democratic-led Congress in a series of legislative battles involving budgetary matters and health care policy. But, particularly aggressive in tone, the speech also had the appearance of throwing down a political gauntlet.

As part of his argument, Mr. Bush took a not-so-veiled swipe at Senator Clinton, the front-runner for the Democratic presidential nomination, despite his promises to stay out of the political fray. In seeking to prove that Democrats really are working toward federalized care as a replacement for the current private medical system, he criticized the comprehensive and famously unsuccessful effort led by Senator Clinton in the early 1990s to reshape American health care and dramatically expand access.

Even without mentioning Mrs. Clinton’s name, he set her up as a chief target by invoking the biggest failure of her past.

“We’ve tried by the way here in Washington to have a major effort to put the federal government square in the center of health care — in 1994 — and the legislation didn’t pass,” Mr. Bush said before a friendly audience, the fall conference of the Grocery Manufacturers Association and the Food Products Association.

“Believe me, the Democrats in Congress who supported that legislation have learned from the experience. So instead of pushing to federalize health care all at once, they’re pushing for the same goal through a series of incremental steps. With each step, they want to bring America closer to a nationalized system where the government dictates the medical coverage for every citizen.”

According to Mr. Bush, those baby steps include allowing younger people into programs designed for senior citizens, allowing adults into programs aimed at children, and allowing the middle class into programs for the poor.

“I’m not making it up,” Mr. Bush said.

The main proof the president offered of Democratic ambitions on health care was an ongoing debate over expanding a children’s health insurance program.

The popular program now provides coverage for 6 million children whose families make too much to qualify for Medicaid but too little to afford private insurance.

Mr. Bush has proposed adding $5 billion to the program over five years. Democrats want to go much further, adding $35 billion over the same period to cover a total of 10 million children by raising qualifying family incomes.

Mr. Bush opposes their proposal to use a tobacco tax increase to pay for the change, and says that any expansion should not raise eligibility substantially, but instead focus on bringing into the program those who already qualify but are not participating.

The debate has already produced one bill and one veto from Mr. Bush, which Democrats failed to override in the House. Now, Democrats are moving ahead with a second bill that is similar to the first, and the president has threatened to veto that one, too.

It has become a key flashpoint between Mr. Bush and Congress, though some Republicans are showing signs they may yet abandon the president on the issue that resonates broadly with the public.

The president said the Democratic approach would “cause moms and dads to give up private insurance,” raise taxes on working people, and put the nation “on a path to government-run health care — which I believe is the wrong path for the United States.”

“It’s really a ‘trick’ on the American people,” he said in his speech delivered on Halloween.

Mr. Bush has repeatedly sought of late to broaden the debate over the SCHIP legislation to one about a philosophical divide between Republicans and Democrats. But this argument hasn’t gained much traction, so the White House dedicated nearly an entire speech to the matter today, one that contained more pointed rhetoric and sharper criticisms.

“At the center of their belief is that folks in Washington are in the best position to decide which diseases should be treated, which procedures you can have, and which doctors you’re allowed to see. That’s the essence of federalization of health care,” Mr. Bush said of Democrats. “They believe that massive tax increases are the best way to fund their plans.”

Mr. Bush suggested that his health care proposals, such as expanding individually owned health savings accounts and allowing small businesses to pool the purchase of health care across state lines, are the better approach. The president also rapped Democratic congressional leaders on other fiscal matters.

He chided Congress for failing to send him any appropriations bills even though the government started a new budget year on October 1, and for drafting bills with higher spending than he wants. Mr. Bush never vetoed a spending bill when Republicans controlled Congress, but he’s itching to do so now to demonstrate fiscal toughness.

“Considering how eager they are to spend your money, it’s shocking how long they are taking to do so,” the president said.