Healthcare proved a divisive issue as the candidates vying to win the Democratic Party’s nomination for president clashed in their latest debate.

Medicare For All has emerged as a theme for those who hope to be duelling next year for the keys to the White House with Donald Trump.

The debate in Atlanta, Georgia prominently featured squabbles over a programme that could alienate general-election swing voters who may be wary of fully government-run, universal health care and that will be extraordinarily difficult to get through Congress even if Democrats take the White House and make significant 2020 congressional gains.

However, Democratic primary contenders cannot stop talking about it and subjecting prime-time audiences to tying themselves in knots over the issue at debates.

Senators Elizabeth Warren of Massachusetts and Bernie Sanders of Vermont, the race’s strongest “progressive” voices, defended Medicare For All, with Mr Sanders saying “Some of the people up here think we should not take on the insurance industry”, but adding: “I think now is the time.”

Former vice president Joe Biden said many people are happy with private insurance through their jobs, while Pete Buttigieg complained about others taking “the divisive step” of ordering people onto universal health care, “whether they like it or not”.

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Democratic presidential candidate Senator Bernie Sanders peaks with Democratic presidential candidate Andrew Yang (John Bazemore/AP)

The debate came at a critical juncture for the Democratic Party, less than three months before the first voting contests and with big questions hanging over the frontrunners.

Some Democrats have grown worried about Mr Biden’s durability, while others fear that Ms Warren and Mr Sanders are too liberal to win a general election.

Those concerns have prompted former Massachusetts governor Deval Patrick to launch a late bid for the nomination, with former New York City Mayor Michael Bloomberg expected to jump in as well in the coming days.

Mr Buttigieg’s rise made him a prime target as Mr Biden, Ms Warren and Mr Sanders look to break out of a four-candidate bunch at the top with less than three months until voting begins.

Mr Buttigieg was asked early about how being mayor of South Bend, Indiana, a city of 100,000 residents, qualified him for the White House and said he was more than up to the challenge.

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Former vice president Joe Biden is among the frontrunners (John Bazemore/AP)

“I know that from the perspective of Washington, what goes on in my city might look small,” Mr Buttigieg said.

“But frankly, where we live, the infighting on Capitol Hill is what looks small.”

Minnesota senator Amy Klobochar interjected to say that having the nation’s first female president was well overdue, adding of the House speaker: “If you think a woman can’t beat Donald Trump, Nancy Pelosi does it every single day.”

In the moderators’ chairs were four women, including Rachel Maddow, MSNBC’s liberal darling, and Ashley Parker, a White House reporter for The Washington Post.

It is only the third time a primary debate has been hosted by an all-female panel to date.

A clash erupted early between two candidates with relatively low polling who were looking for big moments.

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Tulsi Gabbard (John Bazemore/AP)

Senator Kamala Harris of California and Hawaii Representative Tulsi Gabbard, who has criticised prominent Democrats, including 2016 nominee Hillary Clinton.

“I think that it’s unfortunate that we have someone on the stage who is attempting to be the Democratic nominee for the president of the United States who during the Obama administration spent four years full time on Fox News criticising President (Barack) Obama,” Ms Harris said.

“I’m not going to put party interests first,” Ms Gabbard responded.

But the discussion kept finding its way back to Medicare For All, which has dominated the primary, especially for Ms Warren.

She released plans to raise 20-plus trillion US dollars in new government revenue on universal health care.

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President Donald Trump waits the winner of the Democratic primary election (Evan Vucci/AP)

But she also said implementation of the program may take three years, drawing criticism both from moderates like Mr Biden and Mr Buttigieg, who think she is trying to distance herself from an unpopular idea, and Mr Sanders supporters, who see the Massachusetts senator’s commitment to Medicare For All wavering.

Mr Sanders made a point of saying that he would send Medicare For All to Congress during the first week of his administration.