Joe Biden, Bernie Sanders and Elizabeth Warren This Democratic debate, held in Houston at TexasSouthern University, marked the first during this election seasonto be contained to a single night — over the course of three hours.(Photo: Bloomberg)

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Unity was in the air on Thursday, as a trimmed-down cast of 10Democratic presidential candidates met on the debate stage againand nodded to the stakes: the possibility of another four years ofPresident Donald Trump.

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And then the opening statements concluded.

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The first question plunged the candidates into another debateabout the merits and missteps of a "Medicare for All" plan. It wasa fitting set-up for the marquee match-up of this third Democraticpresidential debate, between former Vice President Joe Biden —whose health care proposal includes a government-run public optioninsurance plan — and Sen. Elizabeth Warren of Massachusetts, abacker of Medicare for All, which some advocates see as a way toprovide a single health plan for the entire country and replace allprivate insurance.

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Related: Medicare for All: Where the 2020 presidentialcandidates stand

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But no debate about Medicare for All can exclude the man who, inhis own words, "wrote the damn bill," Sen. Bernie Sanders ofVermont. And within the debate's first moments, there were threepresidential hopefuls batting around big numbers and "to be clear"defenses of their plans.

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The dividing line was drawn: On one side were Warren andSanders, advocating for another major reform of the health caresystem. On the other was Biden.

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"I know the senator [Warren] is for Bernie. Well, I'm forBarack," he said, referring to former President Barack Obama.

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"I think the Obamacare worked," he added. Biden explained hisplan would reinstate aspects of the Affordable Care Act that hadbeen dismantled under the Trump administration andRepublican-controlled Congress, as well as build on it by adding apublic option and expanding subsidies to help people affordcoverage.

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Biden also focused on the price tag — in the case of his plan,about $740 billion, he said.

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"My plan for health care costs a lot of money, but not $30trillion," he said, directly referencing Sanders' Medicare for Allplan. "How are we going to pay for it?"

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"Joe said that Medicare for All would cost over $30 trillion.That's right, Joe," Sanders said. But, he continued, that's a lotcheaper than the $50 trillion he said the current health caresystem would cost over 10 years.

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In an email, a Sanders spokeswoman cited projections from thelibertarian-leaning Mercatus Center that national health spendingwill hit $59.65 trillion between 2022 and 2031.

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Biden charged that neither Warren nor Sanders have completelyexplained how they will pay for Medicare for All.

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"Those at the very top, the richest individuals and the biggestcorporations, are going to pay more. And middle-class families aregoing to pay less," Warren said. "That's how this is going towork."

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This Democratic debate, held in Houston at Texas SouthernUniversity, marked the first during this election season to becontained to a single night — over the course of three hours, to besure. The 10 candidates were the only ones in the sprawling fieldwho met the fundraising and polling criteria necessary to qualify.

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The sharpest exchanges came between Julián Castro, the formersecretary of Housing and Human Development, and Biden over detailsof their health plans. But in his rebuttal to Biden, Castrosuggested that Biden couldn't remember the details he had justdelivered. A PolitiFact check of Castro's statements found that his claimswere mostly false.

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Each candidate staked out a place on the health policycontinuum, such as former Texas Rep. Beto O'Rourke's idea to putthe uninsured on Medicare.

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And at times, some of the candidates would again remind viewers(and one another) that they held more in common than not — that allwere working toward the ultimate goal of universal coverage.

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"Everyone on this stage is well-intentioned," said Sen. KamalaHarris of California. But she also issued a reminder that Trump hasworked aggressively to fight the ACA — even taking it to court —and listed some of its most popular provisions, such as itsprotections for people with preexisting conditions and the abilityto stay on your parents' insurance until you turn 26. "If we don'tget Donald Trump out of office, he's going to get rid of all ofit," she said.

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Sen. Amy Klobuchar of Minnesota noted that she and Sanders hadteamed up on prescription drug issues in the Senate. But when itcomes to Medicare for All, she said, "I go with the doctors' creed:'Do no harm.'"

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"I don't think that's a bold idea," Klobuchar added, voicing hersupport for a public option. "I think it's a bad idea."

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Mayor Pete Buttigieg of South Bend, Ind., also endorsed thepublic option, adding he trusts Americans to "choose what makes themost sense to you."

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The public option is broadly popular, according to a new KaiserFamily Foundation poll released Thursday. About 69 percentof all Americans support a government-administered public optionhealth plan that consumers could choose, the findings showed. About 41 percent of Republicanssaid they support a public option.

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Sanders also raised a few eyebrows when he claimed that 50million people experience at least a temporary gap in theirinsurance every year due to changes to their employment benefits —a number that his spokeswoman later attributed to an analysis from the People's Policy Project, a think tank thatbacks Medicare for All.

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But among other things, Sanders misquoted the analysis: Thethink tank actually makes its claim about adults under age 65 ingeneral — not just those who quit, were fired or experienced someother form of benefits change. (A PolitiFact check found the statement mostly false.)

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The next Democratic debate is set for Oct. 15, with a possiblesecond night on Oct. 16 — depending on how many candidates arestill qualifying (and standing).

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Kaiser Health News isa nonprofit news service covering health issues. It is aneditorially independent program of the Kaiser Family Foundation,which is not affiliated with Kaiser Permanente.

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