At the debate sponsored by the Missouri Press Association, moderator David Lieb of the Associated Press directed his first question to Akin about his statement that a woman cannot get pregnant in cases of "legitimate rape."
"I've answered this question repeatedly and I don't believe this election, overall, is about talk but it is really about two visions of what America is," Akin said.
McCaskill said Akin's comments were "unacceptable" and added that they provided a view into his other positions.
"I think Congressman Akin's comments open the window to his views to Missourians. He has apologized for those comments, but they say a lot about he views things and that's where Missourians need to pay attention," McCaskill said.
Akin took aim at McCaskill's voting record as a member of the Senate and tied her to President Barack Obama. McCaskill fired back and said the St. Louis congressman was part of the "gridlock" in Washington.
Federal spending and the national debt drew contrasts from both candidates with Akin supporting GOP vice president nominee Rep. Paul Ryan's budget plan that would give seniors a subsidy to purchase private insurance plans instead of the current Medicare program.
Akin said Ryan's plan was a good start, but if it were his budget his plan would be "more conservative" and pay down the debt sooner.
McCaskill said Akin ultimately wants to privatize Medicare. If re-elected, McCaskill said she would shrink and deficit and introduce means testing to federal entitlement programs to cut down on fraud and abuse.
In a forum marked by contrasts and disagreements, McCaskill and Akin found some common ground -- the federal government should not be involved at efforts to reduce obesity.
The press forum was held Friday, Sept. 21, in Columbia at the annual Missouri Press Association convention. In addition to Akin and McCaskill, Libertarian Party candidate Jonathan Dine also participated in the forum. Missouri gubernatorial candidates -- Gov. Jay Nixon, Republican Dave Spence and Libertarian Jim Higgins -- also participated in a press forum.
Spence attacked Nixon for his campaign contributions from trial attorneys and said the governor's office was "up for sale." Nixon did not acknowledge the accusations and said Missouri was "headed in the right direction."
When asked about providing relief for children living in the unaccredited St. Louis City and Kansas City school districts, Nixon and Spence both said they would work to boost the districts' performance and dismissed vouchers for students to attend a private school as a solution.