In education and immigration, Jeb Bush is an outlier in the Republican presidential field — a moderate who raises concerns about the ideological direction of the party. But on another flash-point issue, health care, Bush is a proven conservative, having put into action ideas that some GOP rivals can only talk about.

Bush cites his 2005 effort to overhaul Florida’s broken and expensive Medicaid program as a model for using market-driven reforms to cut the growth of health spending and rein in a big government program. It’s not a full-fledged GOP alternative to Obamacare, but it’s a starting point.

On the campaign trail, Bush describes how his Empowered Care pilot program tamed runaway costs. He said recently in New Hampshire, “We need to reform Medicaid, and there’s a plan to do that in Florida that’s a pretty good one.”

But while Bush’s plan, enacted while he was governor, did promote greater choice among private managed-care options, it also sparked a backlash among activists who charged that the very low-income Medicaid population often ended up with less care than under traditional Medicaid.