Julian Castro vs. Biden on Medicare For All: I'm Fulfilling The Legacy of Barack Obama, You're Not


At Thursday's Democratic presidential debate, Democratic presidential candidate Julian Castro aruged with fellow candidate former Vice President Joe Biden about opt-in and opt-out insurance plans and accused him of forgetting what he said two minutes prior about health care.

Castro later said that Biden wants to "take credit" for Obama's work but doesn't want to be questioned about that time.

"If you lose your job, for instance, his health care plan would not automatically enroll you. You would have to opt in. My health care plan would. That's a big difference. I'm fulfilling the legacy of Barack Obama, and you're not," Castro said at the debate moderated by ABC News.

"That'll be a surprise to him," Biden shot back.

Full exchange:

STEPHANOPOULOS: Let me get to Congressman O'Rourke and then bring you -- go ahead, Mr. Vice President.

BIDEN: Fifteen seconds. Look, everybody says we want an option. The option I'm proposing is Medicare for all -- Medicare for choice. If you want Medicare, if you lose the job from your insurance -- from your employer, you automatically can buy into this. You don't have -- no pre-existing condition can stop you from buying in. You get covered, period.

And if you notice, nobody's yet said how much it's going to cost the taxpayer. I hear this large savings, the president thinks -- my friend from Vermont thinks that the employer's going to give you back if you negotiated as a union all these years, got a cut in wages because you got insurance. They're going to give back that money to the employee?

SANDERS: As a matter of fact, they will in our bill.

BIDEN: Well, let me tell you something. For a socialist, you've got -- for a socialist, you've got a lot more confidence in corporate America than I do.

STEPHANOPOULOS: Senator Sanders?

SANDERS: OK, one minute, George?


SANDERS: All right. Two points. You got to defend the fact that today not only do we have 87 million people uninsured and underinsured, you got to defend the fact that 500,000 Americans are going bankrupt. You know why they're going bankrupt? Because they suffered a terrible disease -- cancer or heart disease.

Under my legislation, people will not go into financial ruin because they suffered with a diagnosis of cancer. And our program is the only one that does that.

BIDEN: I know a lot about cancer, let me tell you something. It's personal to me. Let me tell you something. Every single person who is diagnosed with cancer or any other disease can automatically become part of this plan. They will not go bankrupt because of that. They will not go bankrupt because of that. They can join immediately.

And we're talking four, six, eight, ten years, depending on who you talk about, before we get to Medicare for all. Come on. I've been there. You've been there. You know what it's like. People need help now, hope now, and do something now.


STEPHANOPOULOS: Congressman O'Rourke?

O'ROURKE: Yeah. Thank you. Listen, I'm grateful that we all agree about the urgency of this challenge and the fact that Donald Trump is undermining the limited protections that we have right now.

But I also think we're being offered a false choice between those who propose an all-or-nothing gambit, forcing tens of millions off of insurance that they like, that works for them, to force them onto Medicare, and others who want to, as the vice president does, incrementally improve what we have, which will still leave many, maybe millions uninsured and uncared for.

In a state like Texas, where the largest provider of mental health care services is the county jail system, we've got to do better. In my proposal, Medicare for America, says everyone who's uninsured will be enrolled in Medicare. Everyone who's insufficiently insured, cannot afford it, can move over to Medicare. And those, like members of unions who've fought for the health care plans that work for them and their families, are able to keep them. This is the best possible path forward.

BIDEN: You just described my plan.

STEPHANOPOULOS: This is -- health care is the top issue for everyone in the country. I want to make sure everyone gets one minute to respond. So, Secretary Castro, Andrew Yang, and then Senator Booker, you will get a minute.

CASTRO: Thank you. And, you know, I also want to recognize the work that Bernie has done on this. And, of course, we owe a debt of gratitude to President Barack Obama. Of course, I also worked for President Obama, Vice President Biden, and I know that the problem with your plan is that it leaves 10 million people uncovered.

Now, on the last debate stage in Detroit, you said that wasn't true, when Senator Harris brought that up. There was a fact check of that, and they said that was true.

You know, I grew up with a grandmother who had type 2 diabetes, and I watched her condition get worse and worse. But that whole time, she had Medicare. I want every single American family to have a strong Medicare plan available.

If they choose to hold on to strong, solid private health insurance, I believe they should be able to do. But the difference between what I support and what you support, Vice President Biden, is that you require them to opt in and I would not require them to opt in. They would automatically be enrolled. They wouldn't have a buy in.

That's a big difference, because Barack Obama's vision was not to leave 10 million people uncovered. He wanted every single person in this country covered. My plan would do that. Your plan would not.

BIDEN: They do not have to buy in. They do not have to buy in.

CASTRO: You just said that. You just said that two minutes ago. You just two minutes ago that they would have to buy in.

BIDEN: Do not have to buy in if you can't afford it.

CASTRO: You said they would have to buy in.

BIDEN: Your grandmother would not have to buy in. If she qualifies for Medicaid, she would automatically be enrolled.

CASTRO: Are you forgetting what you said two minutes ago? Are you forgetting already what you said just two minutes ago? I mean, I can't believe that 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.

BIDEN: I said anyone like your grandmother who has no money.

CASTRO: I mean, look, look, we need a health care system...

BIDEN: She -- you're automatically enrolled.

CASTRO: It automatically enrolls people regardless of whether they choose to opt in or not. If you lose your job, for instance, his health care plan would not automatically enroll you. You would have to opt in. My health care plan would. That's a big difference. I'm fulfilling the legacy of Barack Obama, and you're not.

BIDEN: That'll be a surprise to him.

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