"Medicare does not deserve to have $716 billion robbed from it to pay for Obamacare," Noem said.
Varilek said Medicare benefits would not be cut, but $716 billion would be saved by making the program more efficient. He said Noem voted for two Republican budget measures that would take the same money from Medicare but use it to give tax breaks to the wealthy.
The Democrat said he wants to preserve traditional Medicare while saving money by making it more efficient. Noem said she supports a plan to keep traditional Medicare for those 55 and older while giving younger people a choice between the existing program or getting private insurance subsidized by the government.
Noem wants to repeal the president's overhaul and replace it with a new effort to reform health care, but Varilek said he wants to keep the law while making some changes. He said the law has helped by preventing insurance companies from denying coverage to people with existing medical problems and allowing young people up to age 26 to remain on their parent's health insurance policies.
While Noem opposes increasing tax rates, she said she supports increasing federal revenue by ending tax loopholes and exemptions. Varilek has said he would raise taxes on households making more $250,000 a year.
Noem again described Varilek as a staunch supporter of Obama.
"He wants to tax you more. He said he would regulate you more. He wants to spend more money," Noem said. She said that puts him out of touch with South Dakota's middle-class families.
Varilek repeated his earlier accusations that Noem supports millionaires and oil companies.
"I think Washington is rigged to serve the wealthiest individuals and the biggest corporations, first and foremost. I'm in the race to be a voice for middle-class families," Varilek said.
"I'm not running to serve the president or anyone other than the people of South Dakota," Varilek added.