That means moving toward nationalizing medical malpractice standards to limit awards, and toward nationalizing the market so customers can buy across state lines, along with statewide "pools" of high-risk patients with pre-existing conditions.
Right now insurance is a state market, based only on state laws, meaning there are 50 different regulatory standards and 50 different legal standards. The Republican plan would move toward changing this. To that extent, the proposal is a reversal of the party's own call for state and local control.
The Wall Street Journal reports the proposal still lets insurers deny sick people coverage, and they could cancel coverage if people become seriously ill.
Democrats pounced on that lack of "guaranteed issuance," but Republicans insist that cost, not coverage, is the issue.
The Hill writes that, after spending months criticizing Democrats for writing a lengthy bill, the Republican proposal will come to 2,000 pages. The party plans an online conference starting at 1 PM Thursday to discuss the measure with their activists.
Regardless of how the proposal is graded, it does represent a concession to Democratic demands that Republicans offer their own bill.
The Republican proposal is guaranteed to be rejected, but now they have something they can offer on the campaign trail next year when voters complain about whatever does pass.
The proposal offers another advantage. It clearly sets terms for future debate. Is it about coverage, or costs? Should the present system be tweaked, or fundamentally changed?
Today may be an off-year Election Day but it does remind us that, in the end, voters will decide which side is right.