Claim: Former Vice President Joe Biden asserted the Medicare for All proposal championed by his progressive rival Sen. Bernie Sanders (I-VT) would require massive tax increases.

Verdict: True.

Biden, one of the only 2020 Democrats to oppose universal health care, made the claim at the presidential primary debate in New Hampshire on Friday.

“It would cost more than the entire … federal budget we spend now,” Biden told the audience, before proceeding to argue the only way to pay for such a plan would be by raising taxes on the middle class.

Sanders’ Medicare for All proposal would create a government-run, universal healthcare system similar to that of countries in northern Europe. The proposal’s most controversial aspect, however, entails the banning of private health insurance. The bill championed by Sanders would make it illegal for private insurance providers to sell health coverage that duplicates the benefits offered by the taxpayer-funded Medicare for All program.

Likewise, the bill prohibits employers from offering coverage to their employees if it mirrors those offered by the federal government. Private health insurance plans could only be sold to individuals or offered by employers if they “provide supplemental coverage” on top of Medicare for All. Other provisions in the bill limit the federal government from subsidizing any private insurance plans.

The Mercatus Center at George Mason University estimates that such a program would cost more than $32 trillion in its first ten years. That sum is nearly equal to the annual budget proposed by President Donald Trump for the 2020 fiscal year. In order to finance such a large sum, most economists estimate that a new revenue stream would need to be established, likely through raising taxes.