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(CNN) —  

Joe Biden says he opposes fellow Democratic presidential contenders’ push for a “Medicare for All” program because such an overhaul of the nation’s health system could not coexist with the Affordable Care Act.

The former vice president, in an exclusive interview with CNN’s Chris Cuomo airing on Monday, argued that former President Barack Obama’s signature health care law, also known as Obamacare, should be expanded to allow people to buy into government-run coverage.

But he said that “starting over would be, I think, a sin.”

“That’s why I’m opposed to any Republican who wants to dismantle it or any Democrat who wants to dismantle it,” he said. “The idea that you’re going to come along and take the most significant thing that happened – that any president has tried to do and that got done – and dismantle it makes no sense to me.”

Biden is the only one of the four top-polling Democratic presidential contenders not to support single-payer health insurance. A switch to single-payer coverage, under a plan proposed by Vermont Sen. Bernie Sanders, would require a tax increase, though supporters have said Americans would spend less on health care overall because they would no longer be required to pay insurance premiums, deductibles and copays.

Some Democrats who have backed single-payer plans say private insurance would continue to exist. But that insurance would likely be supplemental, in addition to primary coverage through a government-run plan like Medicare.

Of his Democratic rivals – including Sanders, Massachusetts Sen. Elizabeth Warren and California Sen. Kamala Harris, who have endorsed Medicare for All – Biden said: “They are saying, if you’re satisfied with your employer-based health care, you’ve got to give it up.”

Biden has instead touted a more moderate approach of building from Obamacare – which for nine years has been under GOP attack. A federal appeals court on Tuesday will hear oral arguments in a lawsuit challenging the law’s constitutionality. The Trump administration is backing Republican states that are seeking to throw out Obama’s signature legislative achievement, which expanded health coverage to include millions more Americans and barred insurers from turning away those with preexisting conditions.

Biden has argued for a “public option” that would allow people to opt into government coverage without eliminating employer-based insurance. It’s the same approach Obama initially sought in 2009, but could not get Congress to include in the Affordable Care Act.

“Now, things are changing,” Biden said of the politics surrounding a public option.

Biden also criticized his Democratic opponents for pushing ideas that would curtail the power of lawmakers and current Supreme Court justices, such as expansive use of executive orders, which Harris has proposed, and adding members to the Supreme Court, which South Bend, Indiana, Mayor Pete Buttigieg has backed.

“The idea that somehow we have decided that our system doesn’t work anymore, which I’m hearing some of them saying – that we’re going to, you know, pack the courts; we’re going to fundamentally change the way, I’m going to do what Trump did; if we take control, I’m going to go in there and I’m just going to, by executive order – what are we talking about?” he said.