In the video introducing his health-care plan, former vice president Joe Biden said Sen. Bernie Sanders’s Medicare-for-all plan “means getting rid of Obamacare.” And when Senator Kamala D. Harris unveiled her alternative Medicare-for-all proposal on Monday, one that allowed for a decade-long transition period and a continued role of private insurance in the system through Medicare Advantage, well, that wasn’t good enough for Biden either. It would, a spokesperson sniffed, “unravel the hard-won Affordable Care Act that the Trump Administration is trying to undo right now.”

On the bright side, Biden’s team did highlight that President Trump and the Republican Party are literally attempting to take access to health care away from millions of people for no reason other than spite — something the Democrats debating on the stage in Detroit Tuesday night somehow barely mentioned. But this hardly puts him in the right on this argument. And it’s almost certainly going to be left to Harris to call him out on it on night two of the debate.

Biden has spent the past several weeks not only debuting his own health-care reform measure, which builds on the Affordable Care Act, but also attempting to scare people into supporting it over ones proposed by other candidates. He has said Medicare-for-all would lead to “hiatuses” of anywhere from six months to three years with the result that people suffering from cancer won’t be able to receive treatment. He also claimed at an AARP forum in Iowa that under Medicare-for-all, “All the Medicare [seniors] have is gone” — a talking point straight out of the Republican playbook.

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The problem with Biden’s approach of promoting his own plan isn’t just that if Trump said what Biden was saying, few would have a problem calling such statements “lies.” It’s also that when Biden does this, he’s making it harder for almost any health-care reform to get off the ground.

The phrase Medicare-for-all is now part of the vernacular as a catchall for any number of health-care reform proposals. Polling shows the public believes the term describes everything from single-payer proposals such as the one Sanders espouses to simple Medicare buy-ins for those over a certain age or lacking access to other insurance. That means the plans of other candidates such as Pete Buttigieg and Beto O’Rourke, who want to begin by allowing people to buy into the existing Medicare program, get demonized by Biden’s attacks as well.

Harris, like Sanders, thinks of her plan as Medicare-for-all. But it’s different in any number of ways. The most important: Sanders completely overhauls the current system, all but eliminating private insurance. Harris, on the other hand, would allow health insurers to continue offering their product within the system, much like Medicare Advantage works now. Yes, it would likely result in changes to the Affordable Care Act, but it would be an improvement over the situation now.

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As many pundits pointed out Wednesday morning, arguing over Medicare-for-all while the Affordable Care Act remains under all but existential threat bears some resemblance to asking Mrs. Lincoln whether she liked the play. But it’s also true that even in the wake of the ACA’s implementation people are still extremely concerned about health care. Deductibles remain increasingly unaffordable and out-of-pocket costs continue to increase at a rapid clip, overwhelming millions. Medicare-for-all is a political issue for a reason, not simply because members of the progressive wing of the Democratic Party have a bug in their ear about it.

Biden’s statements on health-care reform could — and almost certainly will — be used by Republicans seeking to attack almost any Democratic candidate seeking to build on the existing Medicare system to reform health care — something that will need to be done, probably sooner rather than later. Someone must confront him on it. Thanks to Biden’s attacks on her proposal, and the chance that put Sanders and Warren on a different debate stage this round, if anyone is going to stand up to Biden, it will have to be Harris.

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