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For two hours, six Democratic presidential candidates focused on issues of foreign policy, healthcare and the question of electability — particularly the issue of whether a woman could defeat President Trump —in the last primary debate before Iowa caucuses on Feb. 3. On stage were former vice president Joe Biden; former South Bend, Ind., mayor Pete Buttigieg; Sen. Amy Klobuchar (D-Minn.); Sen. Bernie Sanders (I-Vt.); investor Tom Steyer; and Sen. Elizabeth Warren (D-Mass.). (1/15)

Health care was expected to come up in the debate after Mr. Trump this week tweeted that he had saved pre-existing conditions. The Trump administration has backed a lawsuit that would invalidate the Affordable Care Act, which bars insurers from denying people health coverage because of past and current medical issues. ... Candidates sparred over the costs of their proposals, with Mr. Sanders saying the average family would ultimately benefit from Medicare for All whereas Mr. Biden called for reinstating Obamacare with the addition of a public option. Ms. Klobuchar’s point, echoing that of many moderate critics, was that the debate over Medicare for All was largely irrelevant because it is so unlikely to ever pass through Congress. (Siddiqui and Glazer, 1/15)

Warren tried to make the case that every plan proposed by every candidate on the stage is an improvement over the Trump administration’s policy of dismantling Obamacare. But she aggressively attacked the moderates on the stage when they took aim at her proposal. “The numbers the mayor is offering just don’t add up,” Warren said of Buttigieg’s argument that transformational change can happen in healthcare without spending the tens of trillions Sanders and Warren envision. She said the Buttigieg plan simply would not provide the needed relief to a low-income family struggling with medical bills that average $12,000 per year. “You can’t cover that with the kind of money the mayor is talking about,” Warren said. Buttigieg took exception. “It’s just not true that the plan I am proposing is small,” he said. He complained of a “Washington mentality” that he said judges the bigness of a plan by how many trillions it cost and the boldness is judged by “how many Americans you can alienate.” (Halper, 1/14)

Buttigieg's campaign has said his plan, which would create a public option to compete with private insurance, would cost $1.5 trillion over a decade. "We've got to move past the Washington mentality that suggests that the bigness of plans only consists of how many trillions of dollars they put through the Treasury," Buttigieg said Tuesday. Warren has talked less about Medicare for All on the campaign trail amid declining poll numbers. (Hellmann, 1/14)

As in every debate, there was a lengthy domestic policy discussion anchored by health care. The moderators on Tuesday night zeroed in on one of the broad philosophical disagreements between the candidates that rarely gets spelled out: to what extent should the government subsidize healthcare, college, and childcare for all Americans? The use of means testing — requiring those with higher incomes to contribute more for government services — varies across the proposals of the candidates. Sanders is the most consistent, arguing for the largest welfare state across all those categories with the least amount of means testing. His argument is that for government programs to enjoy wide popularity they need to be available to all Americans regardless of income. Buttigieg and Klobuchar, who, for instance, frequently attack free college plans as subsidizing tuition for millionaires, are on the other side of the spectrum. (Lizza, 1/15)

Klobuchar on health care: Medicare-for-all has come up so much in these debates that bringing it up often elicits groans from people who cover these things. Little of it seems new anymore. But Klobuchar carved out her niche on it Tuesday night. “This debate isn’t real,” she said. “I was in Vegas the other day, and someone said don’t put your chips on a number on the wheel that isn’t even on the wheel. That’s the problem. Over two thirds of the Democrats in the U.S. Senate are not on the bill that [Sanders] and Senator Warren are on.” Klobuchar then went a step further, pointing to concrete things she’s done and would do, including on drug importation and a bipartisan bill on lowering drug prices. (Blake, 1/14)

In defending her plan to build on the Affordable Care Act instead of pushing for the more sweeping Medicare for All plans proposed by her rivals, Klobuchar pointed out that more people support Obamacare than approve of President Donald Trump. "I would also note practically, that the Affordable Care Act right now is 10 points more popular than the president of the United States," the Minnesota Democrat said at CNN's debate on Tuesday night. Facts First: While no poll directly compares the two, it's true that Obamacare is better liked. (Luhby, 1/15)

Former Vice President Joseph R. Biden Jr. came under far less scrutiny than his standing as the national front-runner might have merited in the final debate before voting begins in Iowa on Feb. 3. Just as notable, Pete Buttigieg, the former mayor of South Bend, Ind., who has slipped in Iowa, seemed satisfied to make his own case without sharply criticizing his top rivals. New polls in Iowa show that Democratic voters are roughly split between four top candidates: Mr. Biden, Mr. Sanders of Vermont, Ms. Warren of Massachusetts and Mr. Buttigieg. (Goldmacher and Martin, 1/14)

While his son died and he didn’t end up needing the money, Biden says he came away from the experience with a renewed sense of purpose to preserve the Affordable Care Act and help comfort others who are struggling. (Anderson, 1/14)

If the last few Democratic presidential debates are any guide, tonight's will likely delve into health care proposals. Do voters know what we're talking about when we talk about various plans and concepts, including "Medicare for All?" Or any of the other health policy terms that get thrown around? Pretty much no. (Simmons-Duffin, 1/14)

Six presidential candidates took the stage in Des Moines, Iowa, for the last debate before voting begins in February. (1/15)

BERNIE SANDERS: “Medicare for all ... will cost substantially less than the status quo.” THE FACTS: There’s no guarantee that “Medicare for All” will cost less. The nonpartisan Congressional Budget Office said in a report last year that total spending under a single-payer system like Sanders is calling for “might be higher or lower than under the current system depending on the key features of the new system. ”Those features have to do with the design of the system, questions like payment rates for hospitals and doctors, and whether patients are required to pay part of the cost of their care. (Woodward, Boak and Yen, 1/14)

WHAT MR. SANDERS SAID: “Medicare for all will end the absurdity of the United States paying by far the highest prices in the world for prescription drugs and health care in general.” This is exaggerated. Mr. Sanders is correct that nearly every kind of medical service costs more in the United States than in other developed nations. Many health economists believe it is these higher prices paid in the United States that explain the bulk of why the American health care system is so unusually expensive. A Medicare for all plan like the one Mr. Sanders has proposed would have the power to lower such prices by making the government the only purchaser of health care services. (1/14)

“You got 500,000 people going bankrupt because they cannot pay their medical bills.” — Sanders. Sanders often repeats this talking point, asserting that 500,000 people go bankrupt every year because of medical bills. That’s approximately two-thirds of the 750,000 total bankruptcies per year. We’ve previously given Three Pinocchios to Sanders for this claim, which he keeps repeating. (Kessler, Rizzo and Kelly, 1/14)

Kaiser Health News: Sanders Targets Health Industry’ Profits. Are His Figures Right?

At the January Democratic debate, Vermont Sen. Bernie Sanders zeroed in on the question of profits in the health care industry. Under “Medicare for All,” he said, “We end the $100 billion a year that the health care industry makes.” (Luthra, 1/15)