Presidential Candidates Clash Over Health Insurance, Economy in First Democratic Debate

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New York Mayor Bill de Blasio cast the debate as one for "the battle for the heart and soul of our party."

Ten Democrats railed against a national economy and Republican administration they argued exist only for the rich as presidential candidates debated onstage for the first time in the young 2020 season, embracing inequality as a defining theme in their fight to deny President Donald Trump a second term in office.

Health care and immigration, more than any other issues, led the debate. And Massachusetts Sen. Elizabeth Warren, more than anyone else, stood out — on her own at times — in calling for "fundamental change" across the nation's economy and government to address a widening gap between the rich and the middle class.

"I think of it this way. Who is this economy really working for? It's doing great for a thinner and thinner slice at the top," Warren declared shortly before raising her hand as one of the only Democrats on stage willing to abolish her own private health insurance in favor of a government-run plan. "Health care is a basic human right, and I will fight for basic human rights."

The debate marked a major step forward in the 2020 presidential campaign as Democrats fight to break out from a crowded field that has been consumed by one question above all: Who's best positioned to defeat Trump? The candidates will spend the next eight months before primary voting scrapping over that question and the broader fight for the direction of their political party.

Another 10 candidates, including early front-runner Joe Biden, take their turn debating Thursday night.

While Trump is the ultimate target of many Democratic voters, the president wasn't a major feature for most of Wednesday night. Washington Gov. Jay Inslee was one of the few to go hard after Trump, declaring, "The biggest threat to the security of the United States is Donald Trump."

The candidates didn't agree on everything. Ex-Obama housing secretary Julian Castro assailed fellow Texan Beto O'Rourke on immigration in one pointed exchange.

Otherwise, Democrats waged a largely civil debate with moments of modest policy clashes and few instances of the type of bitter confrontation that has dominated politics in the Trump era. The candidates — at least for one night — were content to focus on their views of what America is and should be. No one openly stumbled.

Absent the ugly attacks or missteps of debates in past elections, the two-hour discussion allowed the party to show off its extraordinary diversity. Wednesday's lineup featured three women, one black man and another man of Mexican heritage. Three candidates and a moderator spoke Spanish at times, while Booker, an African American, talked about the violence that left seven people in his own urban neighborhood shot last week.

At one point, Inslee boasted that he alone among the 10 had signed a bill on reproductive rights for women.

Minnesota Sen. Amy Klobuchar spoke up for the women on stage: "I just want to say there's three women up here who have fought pretty hard for a woman's right to choose."

Immigration was on the candidates' minds as they pointed to the searing photos of a drowned Salvadoran father and his toddler daughter at the Rio Grande and blamed Trump and his policies concerning migrants crossing into America illegally.

Former Obama administration housing chief Julian Castro said, "Watching that image of Oscar and his daughter Valeria was heartbreaking. It should also piss us all off."

Warren spent the evening at center stage, a top-tier candidate whose campaign has gained ground in recent weeks as she has released a near-constant stream of policy proposals. She was flanked by lower-tier candidates including Sen. Cory Booker of New Jersey, former Texas Rep. Beto O'Rourke and others who needed big moments to help spark momentum in the crowded field.

Several candidates, including Castro, New York Mayor Bill de Blasio, Rep. Tim Ryan of Ohio and former Rep. John Delaney of Maryland were eager to jab their rivals on issues including health care and immigration.

The modest differences on health care underscored a much louder internal fight over how aggressive Democrats should be on the nation's most pressing issues.

On one side: candidates like Warren who are demanding dramatic change that includes embracing liberal policy priorities like free universal health care, debt-free college, a forgiving immigration policy and higher taxes on the rich. On the other: pragmatic-minded Democrats like Biden — and little-known former Maryland Rep. Delaney — who are calling for modest policy solutions that could ultimately attract bipartisan support.

Most of Warren's rivals Wednesday night, including O'Rourke and Klobuchar, called for universal health care but also favored preserving the private insurance market. Vermont Sen. Bernie Sanders, who will be in a second debate group Thursday night, has proposed a "Medicare for All" system without private insurance.

"We should be the party that keeps what's working and fixes what's broken," said Delaney, one of the few Democrats on stage who represented his party's moderate wing. "Why do we have to stand for taking away something from people?"

De Blasio sought to elbow his way into the conversation to ensure that Warren didn't have the progressive lane to herself. He was the only other person on stage to raise his hand with Warren to embrace abolishing private health insurance.

He cast the debate as part of "the battle for the heart and soul of our party."

Trump, the elephant not in the room, was in the air traveling to Japan for a round of trade talks as Democrats faced the nation for the first time in the 2020 campaign. From Air Force One, he tweeted his take on the night: "BORING!"

Several candidates, including O'Rourke and Booker, needed a breakout moment. That proved elusive on a crowded stage with moderators pressing candidates to stick to strict time limits.

While the candidates have been courting voters in key states for several months already, the vast majority of the nation has yet to pay close attention to the diverse field.

Only 35 percent of registered Democrats say they're paying close attention to the campaign, according to a new poll from The Associated Press-NORC Center for Public Affairs Research. Two-thirds say they're paying some or no attention.