SIOUX CENTER, Iowa - Rick Santorum is usually quite amiable on the trail, but Monday evening at a campaign event at a small Christian college in Sioux Center, he had some tense back-and-forth exchanges with one student and another graduate of the college.

Jason Kornelis, a 23-year-old recent graduate of Dordt College, asked the former Pennsylvania senator about his anti-same sex marriage stance comparing it to when interracial marriage was illegal in this country.

Clearly agitated, Santorum seemed astounded when Kornelis said he couldn't contemplate how this would "be a hit to faith and family in America."

"You can't think of any consequence?" Santorum asked.

Kornelis answered that he did not.

Santorum then said that if same sex marriage was legalized then "their sexual activity" would be seen as "equal" to heterosexual relationships and it would be taught in schools.

"Really- wow- um okay, well let's see if we can have a discussion. We can flesh out some, well, let's look at what's going to be taught in our schools because now we have same sex couples being the same and their sexual activity being seen as equal and being affirmed by society as heterosexual couples and their activity," Santorum said.

"So what is going to be taught to our people in health class in our schools? What is going to be taught to our children about who in our stories, even to little children - what are married couples? What families look like in America? So, you are going to have in our curriculum spread throughout our curriculum worldview that is fundamentally different than what is taught in schools today? Is that not a consequence of gay marriage?" he GOP hopeful asked.

Kornelis said he still did not agree, to which the candidate responded, "I think you're wrong - okay, in fact you have to know you're wrong, because if we say legally if this type of relationship is identical to other type relationships than of course more of it will be taught because this is what the law says."

Santorum also had a tense moment when a student asked him about health care and the Christian responsibility of caring for the poor.

The student said he didn't "think God appreciates the fact that we have 50 to 100,000 uninsured Americans dying due to a lack of healthcare every year," citing a 2009 study out of Harvard University.

"Dying?" Santorum answered before going back and forth about the validity of the study.

"The answer is not what can we do to prevent deaths because of a lack of health insurance. There's - I reject that number completely, that people die in America because of lack of health insurance," Santorum said to a crowd of 100.

"People die in America because people die in America. And people make poor decisions with respect to their health and their healthcare. And they don't go to the emergency room or they don't go to the doctor when they need to," he said. "And it's not the fault of the government for not providing some sort of universal benefit.