In other words, it’s as much about changing the very nature of the Medicaid program — away from an open-ended promise from the federal government and toward a narrowly constrained program — as it is about undoing provisions of the Affordable Care Act.

It’s also telling which parts of Obamacare are being tweaked, and which are being fully repealed. Tax subsidies to help the middle class pay for health insurance under the Affordable Care Act are being reduced, not eliminated. But the tax increases for high-income Americans that Democrats used to help pay for the Affordable Care Act are being scrapped entirely.

A 3.8 percent tax on investment income over $250,000 for a couple would be history, as would an 0.9 percent surcharge on payroll tax above that same level. The Tax Policy Center estimates that would amount to an average tax cut of $54,000 for households making over $1 million.

Finally, in parsing what Republicans really value most in health policy, there is what they didn’t do. The Congressional Budget Office estimated that the House’s version of this legislation would reduce the number of people with health insurance by 23 million; similar estimates of the Senate legislation are expected next week.

But there’s not much evidence that congressional Republicans see those estimates as a reason to devise a new plan that would keep more people insured. Rather, they are barreling ahead — the House voted on its version of the plan before the C.B.O. numbers on the latest version had even been finished.

Then there are the Democrats.

Republicans have shown willingness to do whatever it takes to achieve goals of less federal spending on health care and lower taxes; Democrats have, conversely, displayed a similar approach to get to the goal of more widely available insurance.