Democrats go on the attack against Elizabeth Warren on healthcare, taxes, as 12 presidential hopefuls take the stage.

Twelve US Democratic 2020 presidential hopefuls debated healthcare, the economy, foreign policy and other issues on Tuesday night in the fourth debate of this election season.

The event, hosted by the New York Times and CNN media outlets in Westerville, Ohio, welcomed two candidates who did not make September’s debate: businessman Tom Steyer and Congresswoman Tulsi Gabbard.

Also on the stage were: Former Vice President Joe Biden, US Senators Cory Booker, Kamala Harris, Amy Klobuchar, Bernie Sanders and Elizabeth Warren, South Bend, Indiana, Mayor Pete Buttigieg, former US Secretary of Housing and Urban Development Julian Castro, former US Representative Beto O’Rourke and entrepreneur Andrew Yang.

The debate comes at a critical time, as Biden has seen his once-solid lead in opinion polls in the Democratic race diminished by Warren, a leader of the party’s progressive movement, who has steadily risen over the past two months.

Warren appeared to be the main target of other presidential contenders, who went on the attack against the US senator over her healthcare and tax plans.

Tuesday’s debate was the first since the House of Representatives launched an impeachment inquiry into Donald Trump. It also came amid heavy criticism of the US president’s decision to withdraw troops from Syria, leaving Kurdish fighters without US military support as Turkey launched a military offensive in the northeast part of the country.

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Here’s a look at where the candidates stood on some of the key issues discussed on Tuesday night.

Impeachment

The Democratic presidential contenders defended the congressional impeachment inquiry of Trump, saying the US president needed to be held accountable for his actions and for stonewalling Congress on its inquiry.

The Democratic-led inquiry focuses on Trump’s efforts to pressure Ukraine to investigate his unsubstantiated allegation that Biden, a leading Democratic contender, improperly tried to aid his son Hunter’s business interests in Ukraine. Trump maintains he did nothing wrong.

Sanders, Biden and Warren speaker during the fourth Democratic debate [File: Saul Loeb/AFP]

Biden and Sanders said during the opening minutes of the debate that Trump was “the most corrupt president in history”, and Congress would be remiss if it did not pursue the impeachment inquiry.

Hunter “did nothing wrong. I did nothing wrong,” Biden said.

Biden urged that the focus go back on Trump, saying, “Rudy Giuliani, the president and his thugs have already proven the fact that they are flat lying.” Giuliani, Trump’s personal lawyer, has become a central figure in the impeachment inquiry.

Warren said that “impeachment is the way that we establish that this man will not be permitted to break the law over and over without consequences”.

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Buttigieg said, “the president had left Congress with no choice”. But some Democrats warned that the party should bring Americans on board to support the investigation

“We have to conduct this process in a way that is honourable,” Booker said.

Sanders added that although he hopes Trump is impeached, he wants the American people to know that politicians are also working on other issues.

Healthcare

Tuesday’s discussion on healthcare went down a similar path as during past debates, but with a heightened focus on Warren.

The Massachusetts senator said she would not sign any bill that required a tax increase on middle-class families and promised the proposal, which is also backed by her fellow progressive, Sanders, would lower costs for everyday Americans.

But Warren took fire from her Democratic opponents for refusing to answer “yes or no” on whether her Medicare-for-all plan would raise taxes for the middle classes. Medicare-for-all is a government-run healthcare plan that would eliminate private insurance.

Warren has previously refused to answer direcltly when asked how she’d pay for her proposal, and during Tuesday night’s presidential debate, she once again dodged the question, insisting only that “costs will go down” for the middle classes.

“I have made clear what my principles are here, and that is that costs will go up for the wealthy and for big corporations and, for hard-working middle-class families, costs will go down,” she said.

Biden and Warren speak on stage during the fourth Democratic primary debate [Saul Loeb/AFP]

Buttigieg criticised Warren for her answer, saying her failure to offer a direct response is “why people are so frustrated with politicians” and arguing that Medicare-for-all would “unnecessarily divide this country”.

Sanders, who wrote the Medicare-for-all legislation that Warren has embraced, said it was “appropriate to acknowledge taxes will go up”.

Klobuchar also said, “at least Bernie’s being honest” and arguing in favour of a public option instead.

Jobs

Many candidates on Tuesday stressed the need to improve the nation’s jobs outlook, but they disagreed on how to do carry it out.

Sanders defended his federal jobs guarantee, saying equalising the economy will create the need for more teachers and doctors.

Yang, who backs a universal basic income, said people “do not want to work for the federal government.”

Klobuchar looks on as Castro speaks during the fourth Democratic primary debate of the 2020 presidential campaign season co-hosted by The New York Times and CNN at Otterbein University in Westerville, Ohio [Saul Loeb/AFP]

Promoting her own plan to boost social security, Warren said her proposal would cover retirement for even those in non-traditional positions, like stay-at-home caregivers.

Several candidates at the debate in Ohio, including O’Rourke and Booker, advocated for strengthening unions to keep businesses like General Motors from moving production to other countries.

General Motors was once Ohio’s largest employer, but now it ranks 72nd, according to the New York Times.

Syria

On the foreign policy front, presidential hopefuls have largely scorned Trump’s approach, especially his latest decision in Syria to back Turkey’s offensive.

Biden and Buttigieg, among others, argued on Tuesday night that Trump was abandoning US allies and weakening the country’s standing around the world by abruptly pulling troops from northern Syria.

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Buttigieg sparred with Gabbard, telling the congresswoman she was “dead wrong” for her earlier support of withdrawing troops from Syria.

Gabbard’s previous stance, as well as her decision to meet with Syrian President Bashar al-Assad in 2017, came under fresh scrutiny following Trump’s decision to withdraw US troops from northeast Syria.

Gabbard has criticised Trump for how he’s conducted the withdrawal but said on Tuesday that while Trump has “the blood of the Kurds on his hands … so do many of the politicians in both parties who supported this regime change war”.

Buttigieg said the attacks are “the consequence of a withdrawal and a betrayal by this president of American allies and American values”.

Buttigieg and Gabbard are military veterans.

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Meanwhile, Warren said she supports removing members of the US military from the Middle East in what she said had to be an appropriate, thoughtful way.

“I think we ought to get out of the Middle East. I don’t think we should have troops in the Middle East,” Warren said.

Reproductive health

Democratic presidential candidates offered a variety of ways to maintain a woman’s right to an abortion, despite the issue being largely in the hands of a Supreme Court with a conservative tilt.

Harris said that as president, her Department of Justice would review state restrictions and stop them by executive order if they violate the Constitution. The policy harkens to the enforcement of the Civil Rights and Voting Rights acts, though there is no federal statute protecting abortion.

Democratic presidential hopeful California Senator Kamala Harris speaks during the fourth Democratic primary debate [Saul Loeb/AFP]

Klobuchar said she would propose and enact such legislation, although that would require Democratic majorities in Congress, a stylistic departure for Klobuchar who touts bipartisanship.

Booker like many candidates on Tuesday said he would try to codify the right to abortion. Booker also said he would establish a White House-level Office of Reproductive Freedom.

Gun control

Most presidential hopefuls have vowed to pursue far-reaching limits on guns while standing up to the gun lobby, offering a variety of proposals, including universal background checks, the banning of assault-style weapons and the requirement for gun owners to obtain licences.

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On Tuesday, O’Rourke and Buttigieg exchanged sharp words over O’Rourke’s proposed mandatory buyback of assault rifles.

Buttigieg last week criticised the idea as a “shiny object” that distracts from more achievable efforts such as universal background checks and banning the sale of the weapons and high-capacity magazines.

Buttigieg criticised O’Rourke as not having a plan for how the buyback would work.

O’Rourke said the different ideas are not mutually exclusive. He said gun violence “is a crisis and we gotta do something about it”. O’Rourke said candidates should listen to victims, not polls, consultants and focus groups.

Buttigieg shot back, saying, “I don’t need lessons from you on courage, political or personal”.

Castro received applause for saying that “police violence is also gun violence” and that he would not give officers “another reason to go door to door” by supporting mandatory surrender of assault weapons.

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Castro was the first candidate on Tuesday’s 2020 Democratic primary debate stage to raise last weekend’s death by shooting of Atatiana Jefferson, killed in Castro’s home state of Texas after a neighbour called 911 requesting a welfare check on her Fort Worth home because the front door was ajar.

Jefferson was playing video games early Saturday with her eight-year-old nephew when Fort Worth police officer Aaron Dean fatally shot her within seconds of arriving at her house. Dean has been charged with murder.

Wealth tax

When it comes to a wealth tax, Yang said taxing wealth, as opposed to income, is bad policy, attacking a position supported by several Democrats, including Warren and Sanders.

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“We should not be looking to other countries’ mistakes,” Yang said. “Instead we should look at what Germany, France, Denmark and Sweden still have which is a value-added tax and we give the American people a tiny slice of every Amazon sale, every Google search, every robot truck mile, every Facebook ad, we can generate hundreds of billions of dollars and then put it into our hands because we know best how to use it.”

Warren explained her plan, which she said will give young Americans better economic opportunities – taxing two percent of people’s net worth above $50m and three percent over $1bn.

“My question is not why do Bernie and I support a wealth tax,” Warren said. “It’s why … does everyone else on this stage think it is more important to protect billionaires than it is to invest in an entire generation?”