Sen. Barack Obama (D-Ill.), entering into the fifth day since his controversial remarks about small towns surfaced, told union workers Tuesday that politicians who do not see bitterness in those parts of the country are “out of touch.”

Sens. Hillary Rodham Clinton (D-N.Y.) and John McCain (R-Ariz.) immediately seized on those remarks as “elitist and condescending.”

Obama on Tuesday morning told the Building and Construction Trades union representatives at the Washington Hilton that there is a lot of anger in small towns because of troubling economic conditions, and candidates who do not realize that are not in tune with what voters are saying.

“If anybody denies that people are frustrated and angry and, yes, sometimes bitter, then they are out of touch,” Obama said.

The Illinois senator added that anger and bitterness have to be tied to hopefulness in order to achieve results.

“If you’re not angry about something, then you're going to sit back and let it happen to you,” Obama said. “I’m mad, but I’m also hopeful.”

However, despite multiple explanations for the remarks at the fundraiser, Obama’s comments are not going away with the Pennsylvania primary just one week away. Clinton's campaign said Tuesday it is an issue it will continue to push to the forefront of the debate.

The Clinton campaign began running an ad in the Keystone State featuring Pennsylvanians who say they were outraged by Obama’s remarks.

“The good people of Pennsylvania deserve a lot better than what Barack Obama said,” one man says in the ad.

Howard Wolfson, a senior Clinton adviser, said on a conference call Tuesday that the ad raises important questions and the remarks are “something we intend to continue to discuss.”