Thursday's Democratic debate at Houston's Texas Southern University opened with the most heated topic of the night: healthcare.
The third round of debates marked the first time front runners former Vice President Joe Biden, Senator Bernie Sanders, and Senator Elizabeth Warren shared the stage. While Sanders and Warren are supporters of Medicare for All (Sanders "wrote the damn bill," as he's often pointed out), Biden prefers a plan that expands on the existing Affordable Care Act.
The trio had mostly strong—but diplomatic—words for one another on the subject. Biden targeted the opposing plan's high price tag, which Bernie and Warren argue will be covered through increased taxes on corporations and wealth.
"My plan for health care costs a lot of money," said Biden. "It costs $740 billion. It doesn't cost $13 trillion."
Biden also criticized Warren for failing to be upfront about the likelihood that middle-class taxes will rise under Medicare for All. Warren, however, insisted on re-framing the picture to argue that overall costs will go down with the elimination of high deductibles and co-pays.
"What we're talking about here is what's going to happen in families' pockets, what's going to happen in their budget," she said, "and the answer is, on Medicare for All, costs are going to go up for wealthier individuals and costs are going to go up for giant corporations. But for hard working families across this country, costs are going to go down."
Biden called the likely rise in taxes for the middle class "a deductible in your paycheck," arguing an individual making $60,000 would have to pay 4% more in income tax. "That's the reality. That's not a bad idea if you like it. I don't like it."
Like some of the other candidates, Biden's plan allows Americans to keep their private insurance plans if they so choose. Medicare for All, on the other hand, will eventually eliminate such plans—revoking peoples' right of choice, opponents say.
"Maybe you've run into people who love their premiums. I haven't," Sanders told Biden.
"I've actually never met anybody who likes their health insurance company," Warren said. Under Medicare for All, she added, "people will have access to all of their doctors, all of their nurses, their community hospital, their rural hospital."
While the front runners remained heated but civil, the sharpest comment of the night arguably came from former Secretary of Housing and Urban Development Julián Castro, who took a swing at Biden over a prior statement.
"Are you forgetting what you said two minutes ago?" Castro chided, playing off the frequency of Biden's public blunders.
Castro had stated that "the difference between what I support and what you support, Vice President Biden, is that you require them to opt in. I would not require them to opt in. They would automatically be enrolled."
When Biden countered that his plan would not require individuals to buy in, Castro threw down the gauntlet. "You said two minutes ago that they had to buy in, and now you're saying they don't have to buy in. You're forgetting that."
"If you lose your job, for instance," Castro continued, "his healthcare plan would not automatically enroll you. You would have to opt in. My healthcare plan would [enroll you]. That's a big difference. I'm fulfilling the legacy of Barack Obama and you're not."
Biden had earlier said that if someone lost their job, they could "automatically buy into" his plan. Later, he said those who need care "can join immediately."
The clash between Biden and Castro was diffused by South Bend Mayor Pete Buttigieg, who said such behavior "reminds everybody of what they cannot stand about Washington: scoring points against each other, poking at each other."
"That's called an election," said Castro.
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