Senators Bernie Sanders, Ted Cruz, are miles apart on Obamacare replacement

A CNN debate between Independent Senator Bernie Sanders of Vermont and Republican Senator Ted Cruz of Texas brought out the difference between Sanders and the Democrat's plan for health coverage under Obamacare and the Republican replacement proposal that wants to keep government out of healthcare choices.

Sanders and Cruz covered a lot of familiar territory as rivals from last year's presidential race, during the 90-minute-plus town hall debate hosted by CNN anchor Jake Tapper and chief political correspondent Dana Bash.

"We should move in the direction of healthcare as a right and not a privilege," Sander said

"Bernie and the Democrats want government to control healthcare," Cruz said.

[Also: Trump hints Obamacare repeal could stretch into 2018 in Bill O'Reilly interview]

Sanders promotes a single-payer system, or Medicare for all, while Cruz said Sanders' plan would result in "rationed" healthcare and long wait times as is seen in countries that have a government-run system.

Sanders said the United States has rationing for people who don't have the money to buy what they need. There needs to be a public option to lower cost and provide competition, he said.

"I would like to see a lot more people on private insurance," Cruz said. "We want as many people as possible to afford insurance policies that protect you."

A GOP replacement plan to the Affordable Care Act would allow people to purchase plans across state lines, expand health savings accounts, and make health insurance portable, from job to job, Cruz said.

Sanders told the audience that in the plan put forward by Cruz and the Republicans, "you are on your own." Congress is more interested in serving wealthy Americans, he said, which means billionaires are buying elections and influencing policy.

If the ACA is repealed, the top 1 percent of taxpayers get a tax cut that adds about a third to their income, Sanders said.    

The ACA replacement proposed by Republicans offers access to coverage, but does not guarantee health services, Sanders said.

[Also: Hospitals face big financial hit under Obamacare repeal, analysts say]

Cruz compared Sanders' solution of making fixes to the ACA to the SNL skit featuring actor Christopher Walken in which the answer was always "more cowbell."

The senators agreed that insurance premiums are too high, that physicians have too much administrative paperwork, and that Medicare should be negotiating drug prices with the pharmaceutical companies to keep down the cost.

Cruz said the FDA should lift barriers to get drugs to market faster.

Sanders said the United States pays the highest prices in the world for prescription drugs and he would be proposing legislation to allow Medicare to negotiate with big pharma.

Questions from the audience brought up their differences in ACA policy for essential benefits, coverage for preexisting conditions, the employer mandate and Medicaid expansion.

Cruz said under Obamacare a 60-year old man is required to get a plan with maternity coverage.

Sanders said under the GOP, there will be massive cuts in federal funding for Medicare and Medicaid.

[Also: Trump needs to veto GOP plan for Medicare, Dems, Sanders say]

"The problem is Medicaid is a profoundly troubled program," Cruz said.

The solution is for people to have the private health insurance of their choice, Cruz said.

Texas has the highest number of people who are uninsured, Sanders said, while Vermont is number two for the percent of people who have insurance. Massachusetts, under Romney care, the prototype for ACA, has the highest level of insured residents.

More people are moving to Texas, Cruz said. "People vote with their feet. Vermont is a lovely state, but it doesn't have a ton of diversity."

President Donald Trump has made repealing and replacing the Affordable Care Act one of his top priorities.

Twitter: @SusanJMorse