U.S. Rep. Mazie Hirono on Wednesday questioned whether former U.S. Rep. Ed Case would place federal budget concerns over issues such as women’s health if he were elected to the U.S. Senate, while Case suggested that Hirono is too far to the left to effectively represent the political mainstream in Hawaii.

In the liveliest exchanges so far in their Democratic primary campaign, Hirono, a liberal, used a Hawaii Public Radio debate to link the moderate Case to national Republicans. Case cast Hirono as an out-of-step progressive who is more of a follower than a leader.

Hirono cited a Case vote in favor of an unsuccessful House Republican spending cut proposal in 2005 that would have slashed funding for family planning, the arts and public broadcasting.

"Today Planned Parenthood and women’s health services are under attack," Hirono said. "With your record of putting Republican budget principles ahead of Planned Parenthood and women’s health services, how can we trust you to stand up for women’s access to these services?"

Case accused Hirono of "cherry-picking" one of the thousands of votes he cast while in Congress and said he has consistently been rated highly by women’s organizations. He said the vote she mentioned "stood for fiscal responsibility."

"It stood for trying to implement reasonable, direct fiscal restraints, so that we did not go over the top in terms of our budget," he said.

"I felt it was important at the time."

Case questioned Hirono’s vote this year for a failed budget proposal from the Progressive Caucus that included hefty tax increases and deep cuts to defense spending.

"I think the issue here, Mazie, is, is your philosophy one that is mainstream enough to represent the majority of voters in Hawaii? Or are you going to govern and think and operate from an extreme, which is not what we need in Washington today?"

Case, who served in the moderate-to-conservative Blue Dog caucus, said Hirono and the Progressive Caucus reflect the "far left" of the House.

Hirono said the Progressive Caucus budget represented an alternative approach that would have brought more balance to defense and domestic initiatives.

"I’m proud to be a progressive, someone who cares about equal opportunity and justice for the people in our country, who cares about our seniors," she said. "At the same time, I have a reputation of working very well with others in my own caucus as well as across the aisle on behalf of projects for Hawaii."

Case said the Senate needs more leadership voices from the mainstream to solve the nation’s challenges.

"If you simply yell from the far left at the far right, nothing is going to get done to solve our challenges," he said. "And I’m asking you, Can you get beyond that?"

"I don’t think any of my colleagues hear me yelling from the far left," she responded. "In fact, what they see me doing is working very hard every single day to get things done for the people of Hawaii.

"And frankly, that’s what the people of Hawaii care about. They want somebody who is responsive to them, who listens to them."

The Hawaii Public Radio debate was the third of five scheduled joint appearances with Hirono and Case before the Aug. 11 primary. The one-hour debate, moderated by HPR political reporter Wayne Yoshioka, was the first that explored a wide range of public-policy topics.

A forum hosted by the Hawaii Lodging and Tourism Association in late May concentrated on tourism, while a debate sponsored by AARP Hawaii on Tuesday centered on Social Security and Medicare.

The Democrats who want to replace retiring U.S. Sen. Daniel Akaka, D-Hawaii, will debate again at 8 tonight on PBS Hawaii.

Both Hirono and Case said they can beat former Gov. Linda Lingle, the leading Republican candidate for Senate, in the November general election.

Case said he would be able to appeal to the moderate voters that Lingle would need to win in traditionally Democratic Hawaii. Hirono said the television advertising buy by the U.S. Chamber of Commerce on behalf of Lingle and Lingle’s own ad debut this week shows that the former governor needs an "extreme makeover."

Hirono said she would remind voters that Lingle, who is campaigning as bipartisan, supported former Alaska Gov. Sarah Palin for vice president in 2008 and criticized Hawaii-born President Barack Obama on the campaign trail on the mainland.

Both Hirono and Case also said they would support overturning the federal Defense of Marriage Act, which defines marriage as between a man and a woman.

While same-sex marriage will not be an issue in the primary, it could be against Lingle in November. Lingle, as governor, vetoed a civil unions bill because she said it was the equivalent to marriage. She said at the time that such a controversial issue should be put before voters.