payouts have to hit certain percentages, forcing insurers to capture the bottom line by managing their costs on the rest?

This is how I remembered it, but I'm getting increasingly forgetful.

Sadly, while the Dems made a fairly honest effort to increase access to insurance, I think it is clear that neither party has a clue (and not much incentive) to reduce healthcare costs. I would guess neither cares to cross lobbyists whose goal is raise the profits of hospitals and doctors.