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2020 Democrats signal showdown over the future of health care

Myrtle Beach, South Carolina(CNN) Kamala Harris repeatedly brought the crowd to its feet, with a forceful call at a campaign stop here on Monday to restore decency to the White House and a subtle nudge for Democrats "to turn the page and write a new chapter in our history."

Yet the first question from a voter -- on health care -- points to one of most animating issues for the Democratic electorate and a key challenge facing her candidacy as she breaks through the crowded 2020 field.

"We cannot go immediately into health care for all," Joe McVay told Harris, rising from his seat to deliver an urgent warning that he believes implementing "Medicare for All" and abolishing private health insurance would be a death knell for Democrats.

For nearly three minutes, the California senator explained her view, finally saying: "To your point, it can't just happen overnight. There will be a transition period."

Harris has drawn considerable new attention to her candidacy after confronting Joe Biden on his record of race, his wistful words for segregationist senators and his forceful opposition to federal busing programs to desegregate schools decades ago.

But for all of the attention paid to this unusually fierce exchange, the Democratic presidential contest is almost certain to turn on modern-day issues like health care, which is emerging as the next critical point of contention between Biden, Harris and other rivals.

The distinctions will surely be front-and-center at the CNN debate on July 30 and 31 in Detroit.

"On health care, we strongly disagree," Biden said Sunday in Charleston as he made his own campaign swing through South Carolina. "I don't want to do away with Obamacare, start all over and trash it."

The former vice president favors an expansion of the Affordable Care Act by allowing people to buy into government-run coverage. In a position that pits him against his closest rivals in the 2020 race, Biden said he opposes the push for a Medicare for All program, arguing it would all but destroy former President Barack Obama's signature health care law.

"Starting over would be, I think, a sin," Biden told CNN's Chris Cuomo in an interview broadcast Monday evening.

"That's why I'm opposed to any Republican who wants to dismantle it or any Democrat who wants to dismantle it," Biden said. "The idea that you're going to come along and take the most significant thing that happened -- that any president has tried to do and that got done -- and dismantle it makes no sense to me."

Sens. Bernie Sanders of Vermont and Elizabeth Warren of Massachusetts are leading the charge for "Medicare for All."

"I'm with Bernie on Medicare for all," Warren said at the first Democratic debate.

"There are a lot of politicians who say, 'Oh, it's just not possible, we just can't do it, there's a lot of political problems," Warren said, before sharpening her language: "What they're really telling you is they just won't fight for it. Well, health care is a basic human right and I will fight for basic human rights."

Harris has tried to take a more nuanced position while still supporting the same overall goal, which has has opened herself up to criticism from both sides on health care, with Sanders implying her views aren't pure and Biden suggesting they are simply wrong.

Harris has publicly signaled her support for eliminating private insurance, only to try to walk it back after the Democratic debate in Miami late last month and earlier this year after a CNN town hall in Iowa.

Here in Myrtle Beach, Harris' struggle to articulate a clear or consistent position on health care was raised as a point of concern by McVay and several voters, who otherwise spoke admiringly of her candidacy.

"She'd make a great president, don't get me wrong," McVay said. "But she can't get pulled too far to the left on this."

A dramatic overhaul of the health insurance system has gained enthusiastic support from liberals, but several self-described moderate voters here expressed concern over the direction of the health care debate and the overall tone of the primary discussion. A CNN poll conducted at the end of June showed 85% of Democrats and Democratic-leaning independents support a national health care program for all Americans, but only 30% of those respondents want to get rid of private insurance.

"They are nice thoughts and directions we definitely should be looking into, but I don't think someone from the far, far left will be the nominee," said Joe Simpson, a Myrtle Beach retiree who said he is impressed by Harris' rise and is closely watching her candidacy.

There is little question Harris is having a moment, which was made clear by the crowd of more than 1,000 people who came to see her at the Myrtle Beach Convention Center on Monday afternoon. She has steadily sharpened her case against President Trump, now referring to him as a "predator in the White House," as she delivers a far more confident argument than she did a few months ago.

"This is a fight that is not only for the soul of our country," Harris said, speaking over rousing applause. "This most importantly is a fight that is born our of love of country and this is a fight we will win."

Conversations with a dozen voters in the audience offered similar views of Harris: They increasingly see her as someone who can go toe-to-toe against Trump; she proved her mettle against Biden but shouldn't keep pressing him on racial issues; they hope she isn't pulled too far from the ideological middle.

"She's awesome. She has a lot of spunk and can defend herself against Trump," said Ruth Simpson, who attended the campaign event with her husband. "I will say I wasn't that happy with her in this debate because I didn't like how she treated Joe Biden."

But it also may have worked.

Simpson echoed the sentiment of several other voters here, who spoke with respect and admiration for Biden, even as they said it's time for the party to elect a new leader, possibly Harris. She said she may start volunteering for Harris' campaign.

"I love Joe Biden," Simpson said, pausing as she carefully chose her words. "But I'm not sure if he has the stamina or endurance or sharpness that he needs to go against Trump."

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