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Democratic presidential candidates sparred over health care at the Iowa Democratic Party’s annual Liberty and Justice Celebration, a big event for Democrats and supporters that filled a basketball arena in downtown Des Moines. The fundraiser marked the beginning of the final three-month stretch leading up to the Iowa caucus, and was an opportunity for top-tier candidates to see their campaigns launch like Barack Obama’s did in 2008.

The event came after Senator Elizabeth Warren unveiled her much-anticipated proposal to pay for Medicare for All earlier on Friday. She claims she can fund the plan without raising taxes on middle-class Americans “by one penny.”

After accusing Warren of “mathematical gymnastics” in a campaign email on Friday, former Vice President Joe Biden did not address Warren’s plan directly in his speech Friday evening, although he took a swipe at her and Senator Bernie Sanders by saying his health care plan would not take “four years or five years or ten years to happen.”

“There will be no increases in taxes for the middle class. None. None. None,” Biden said about paying for health care reform, in an oblique reference to Warren and Sanders. Biden has emphasized the need to build upon and preserve the Affordable Care Act, which was signed into law by President Obama while he was vice president.

Warren responded with an indirect swipe at Biden, saying in her speech that “it’s easy to give up on a big idea, but when we give up on a big idea, we give up on the people whose lives would be touched by that big idea.”

“Anyone who comes on this stage and tells you to dream small and give up early is not going to lead our party to victory,” Warren said.

Meanwhile, Sanders — the architect of a Medicare for All proposal in Congress — promised supporters at the event: “We will pass, whether the insurance companies like it or not, Medicare for All.”

Senator Kamala Harris struck a balance by promising Medicare for All with the option to keep private insurance.

“I am running for president to make sure there is Medicare for All to bring down costs, and to ensure that you also get choice,” Harris said.

A New York Times/Siena College poll published on Friday showed Warren leading in Iowa in a tight race, with Sanders, Mayor Pete Buttigieg, and Biden close behind. However, the margin of error in the poll was plus or minus 4.7%, meaning that the top three candidates — Warren, Sanders, and Buttigieg — are virtually tied.

Although her frontrunner position in Iowa may be tenuous, enthusiasm for Warren could be seen at the event on Friday. CBS News’ Caitlin Huey-Burns reported that the section of the stadium seating Warren supporters unfurled a banner during her speech, saying: “Win with Warren.”

Musadiq Bidar contributed to this report.