Healthcare policy united Democrats and helped propel them to massive victories in the 2018 congressional election. But on the first night of the 2020 presidential primary debates, the issue proved to be one of the first deeply divisive topic for the ten candidates on the stage.

Several candidates clashed over whether private insurance companies would have a place in a system that offers universal healthcare. Former Rep. Beto O’Rourke (TX) said the option to choose private health insurance was “fundamental” towards providing “choice” to consumers, though he favored a dramatic expansion of Medicare along with the opportunity being afforded to everyone to buy into it. The response provided an opening for others on the stage, who have endorsed ending private insurance altogether. And New York Mayor Bill De Blasio jumped at it.

“How can you defend a system that is not working?” De Blasio asked O’Rourke.

As Democrats have navigated a crowded primary field, virtually all have called for a massive expansion of insurance coverage while criticizing President Donald Trump for undermining Obamacare. But they’ve disagreed on the specifics, with some promoting a single payer approach and others calling for relying on a so-called public option for insurance.

What was less expected, until Wednesday night, was fulsome defenses of the private industry. But former Rep. John Delaney (MD) provided one. He cut in after De Blasio, saying private insurance plans were essential to sustaining medical services since, he argued. providers couldn’t rely solely on Medicare reimbursement rates.

“We should be the party that keeps what's working and fixes what's broken,” Delaney said.

Delaney brought up his union electrician father’s union health insurance, and suggested that eliminating private insurance would hurt labor voters — a key Democratic constituency.

“I think about my dad in anything I do from a policy perspective,” Delaney said. “He would say, ‘Good job, John, for getting healthcare. Why are you taking mine away?’”