A lot of people who have shared the exchange have focused on Sanders’s case for health care as a right and his interruption of Price to contest whether the United States is a “compassionate” society. As arresting as the Vermont senator’s intrusion was, though, the more telling portion of the clip comes from Price’s side, and it shows just how thoroughly trapped Republicans are on health care.

The first time Price tries to answer whether health care is a right, he starts talking about U.S. society (rather than the government) before Sanders interrupts him. The second time, he answers, “I believe and I look forward to working with you to make certain that every single American has access to the highest-quality care and coverage that is possible.” As Sanders points out, ” ‘Has access to’ does not mean that they are guaranteed health care.” Price dodges again: “And that’s why we believe it’s appropriate to put in place a system that gives every person the financial feasibility to be able to purchase the coverage that they want for themselves and for their family. Again, not what the government forces them to buy.”

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At several points in the conversation, Price could have simply said, “No, I do not think health care is a right.” But he didn’t. It’s not surprising to see Price and other Republicans promise that people with preexisting conditions will still be able to get coverage or that children will be able to stay on their parents’ insurance until they’re 26. Those are concrete benefits of the Affordable Care Act that people could lose, and taking them away is politically difficult. But Price — who has said that “nothing has had a greater negative effect on the delivery of health care than the federal government’s intrusion into medicine through Medicare” — wouldn’t even challenge Sanders on these more theoretical grounds.

It’s a remarkable shift in the debate since the beginning of Barack Obama’s presidency. Though the outgoing president believes health care is a right, the ACA does not assume that. During the debate over the ACA, those who felt mostly strongly about a right to health care pushed a single-payer system or at least a public option, and they lost. And yet Price, with impending GOP control of both houses of Congress and the White House and facing a law that they claim is collapsing and terribly unpopular, submitted to this leftward shift in the debate. If a right to health care becomes the unchallenged middle for the debate, that tips the scales toward the Democrats in what possibilities there are for replacing the law.