Not really at odds at all

In the HWR Joe Paduda made the following point, which has been made by others on the left;

"- most GOP-authored bills allow people to shop for insurance across state lines, which seems to be at odds with other GOPconcerns that health insurance should be the purview of the states, and the Feds ought not to be involved"

There is nothing at odds in this belief and it has been settled case law for decades. Insurance is regulated where it is sold. This means if I live in MA but drive to DE to purchase an insurance policy the policy will be regulated in DE where it was sold. This is not only commonly done between states but also countries. There are types of risk, usually P&C, that businesses and individuals will insure offshore. Since the policy is purchased outside of America it is not subject to American insurance laws. You need to be careful when you do this as there are tax issues and money laundering concerns but as long as you are legitimately purchasing insurance for an insurable risk, leaving the jurisdiction where the risk resides to buy insurance in another jurisdiction in order to be subject to that jurisdiction's laws is far from new or uncommon, despite what the left would like you to believe.