THE DEBATE over affordable medical care has gotten heated since Sen. Elizabeth Warren of Massachusetts released her health care plan last week.

After former Vice President Joe Biden called Warren’s proposal “mathematical gymnastics,” Warren implied Biden’s ideas were too conservative for the Democratic party. Biden’s response was to call Warren unwilling to listen to ideas other than her own.

Biden’s New Hampshire campaign has stayed more upbeat on health care. Locally, the campaign has focused on talking up the Affordable Care Act, releasing a series of 14 short videos about Granite Staters helped by Obamacare.

Lesser-known moderate candidates are seizing the moment too.

Colorado Sen. Michael Bennet scoffed at single-payer plans in Concord on Wednesday, after he filed his candidacy papers with the Secretary of State. “I think that proposal is un-passable in America. It couldn’t pass in Vermont!” Bennet told reporters.

Like Biden, Bennet supports a public option for health insurance — a plan Bennet has dubbed “Medicare-X.”

Warren said in her policy proposal that she would soon unveil a plan for transitioning to single-payer health insurance.

In a statement, the New Hampshire Hospital Association said it would be opposed to a single-payer system. Association president Steve Ahnen said he thought a Medicare for All system would “upend” a system that is working, and expressed concern that hospital finances would be adversely affected, because government health insurance programs like Medicare and Medicaid typically reimburse hospitals at lower rates than private insurance providers. Warren plans to increase the reimbursement rate to hospitals for many services, according to her plan.

Single-payer advocates say it is exciting to see a once-fringe idea become a defining question in the Democratic primary.

Daniel Barlow is the president of an advocacy group called “Business for Medicare for All.” Barlow, a Nashua native, said the group’s 2,500 members are interested in Warren’s proposals to contain health care costs, and make those costs more predictable from year to year.

“Serious economists and serious policy analysts are looking at how you would implement Medicare for All in this country,” Barlow said. “That’s a sea change in the conversation from just a few years ago.”

Warren out front in new Iowa poll

Warren is still very much a front-runner, which might be why she is such an appealing target for other candidates.

A poll of Iowans conducted by Quinnipiac University showed 20% of likely caucus-goers support Warren — slightly higher than the 18% of New Hampshire primary voters who support her. South Bend, Ind., Mayor Pete Buttigieg has the support of 19% of Iowa poll respondents, and Vermont Sen. Bernie Sanders had 17%. The poll shows 15% of likely caucusers support Biden.

Rep. Tulsi Gabbard of Hawaii, after criticizing the Democratic National Committee for winnowing the debate fields by keeping the lowest-polling candidates off the stage, seems to have started benefiting from the system. With the Quinnipiac poll, she secured a spot in the Nov. 20 debate.

Stirrings from the Trump campaign

Vice President Mike Pence’s trip to New Hampshire Thursday is the first time a member of President Donald Trump’s administration has visited New Hampshire since Trump’s campaign rally in August. Pence is visiting to file candidacy papers for Trump’s reelection campaign.

But behind the scenes, the campaign has been more active.

Nina McLaughlin, a local spokesman for the Trump campaign and the Republican National Committee, said the campaign used Tuesday’s municipal elections as a sort of test run for the 2020 get-out-the-vote effort.

The volunteering, she said, is as much about building a social infrastructure as it is about training campaign volunteers.

On Friday, a pizza-fueled phone banking session ended with the 15-odd volunteers watching a Trump rally together.

A Wednesday “Women for Trump” training in Hampton Beach included plenty of opportunity for volunteers to network and socialize as they took in training on voter contacts and social media.

“Everyone likes the social aspect,” McLaughlin said.

Contact Josie Albertson-Grove at Granite Status is published every Thursday.

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