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LE MARS, Iowa -- Former Vice President Joe Biden came to Northwest Iowa on Tuesday to discuss his plans to boost rural America, asserting that access to quality health care is crucial to living well and that keeping smaller hospitals open is important in regional economies.

Biden, the front-runner in the 2020 Democratic race for president, discussed rural health care issues at a Le Mars hospital. He started the afternoon by taking a private tour of Floyd Valley Healthcare and then held a roundtable with seven local health care officials, which was observed by 35 local residents and members of the press.

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"I know there is still a crisis in rural hospitals," Biden said, beginning his remarks for the 35-minute forum.

Dr. Andrew Geha, a family practice physician provider at Floyd Valley, said too many patients have health care plans they thought were great, but find out they have high deductible amounts.

"It leaves them in the hole, having to pay that deductible," Geha said.

Biden said his top points regarding health care are to keep rural hospitals open and to reduce out-of-pocket expenses paid by Americans. He said the maximum deductible anyone should pay for medical expenses annually in an insurance plan is $1,500.

Additionally, Biden said he doesn’t support “Medicare for All,” but proposes that people pay amounts for health insurance policy premiums based on a sliding scale of income.

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“The problem with Medicare for All is it would bankrupt a lot of hospitals,” Biden said.

That puts him at odds with the more progressive wing of the Democratic Party, where some, including fellow presidential candidates, want to replace the current insurance system with a fully government-run model.

Biden also said he would defend rural hospitals by making sure Republicans do not repeal the 2010 federal health care reform pieces enacted as the Affordable Care Act. That’s a topic he also addressed on Monday in Des Moines, in a multi-candidate AARP forum.

Biden, who is also a former U.S. senator from Delaware, began Tuesday with a campaign event in rural Manning, Iowa, where he first spoke about rural health care with 200 people. After his health care event in Le Mars, he spoke at a rally in Sioux City on Tuesday night.

The stops in Northwest Iowa are Biden's first in the 2020 presidential cycle.

A field of more than 20 Democrats are competing to become the party's nominee, as Republican President Donald Trump seeks re-election. Biden, who was vice president for eight years in the Obama administration, is ahead in most state and national polls, though his lead has been shrinking in recent weeks.

Associated with his events in Iowa, Biden's team released his plan to revitalize rural places. That plan said the agricultural sector would be strengthened by a trade policy that reverses the tariffs placed with China by Trump, since that has damaged the farm sector.

Additionally, the plan would help beginning farmers by expanding a loan program to serve people who grew up on farms and don’t have full capital to start a farm. Therefore, Biden would double a prior Obama administration program for such loans, with the ability to get such loans of $100,000.

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