Isakson, one of Georgia's two Republican senators, voted against the reform and has vowed to repeal it. He cosponsored legislation to dismantle parts of the new law, including requirements that individuals purchase coverage and the taxing of employers for not offering it.
"I will work to fight this law every step the way," he said in August.
Thurmond, though, is not so vocal. In an interview published Thursday by the blog Progressive Blue, he was asked if he would have voted for the law had he been in the Senate at the time.
"That's a hypothetical I'd rather not answer," he was quoted as replying.
When questioned Friday by Morris News, he acknowledged that the law could be improved.
"Let's take a look at what is working and improve on it and change what is not working," he said, adding that voters are fed up with politicians who oppose or support the law merely for partisan reasons.
While Isakson backs efforts by Georgia and 19 other states to challenge the constitutionality of the law's insurance-purchase requirement, Thurmond, who is a lawyer, dodged that question as well.
"That is for the courts and our judicial system to decide," he said. "I do know that we require automobile insurance, and this has not been found unconstitutional."
Polls show that only one of every three Georgians supports the law, math that every politician recognizes. It gives Isakson confidence when he boldly opposes it.
"The health care law will have a devastating impact on our nation. ... The policy mandates in this bill are being challenged by states and rejected by voters," he said.
Yet, there are parts of it that both Isakson and Thurmond agree with.
They both favor outlawing the denial of coverage to people with medical conditions that existed before they applied for insurance. And they like allowing children to stay on their parents' plan up to age 26.
Both agree with ending the so-called "doughnut hole" in Medicaid funding for prescriptions that currently leaves about 8 percent of upper-middle-income senior citizens with less coverage than those with higher or with lower incomes.
Thurmond, as the state's labor commissioner for the last 12 years, he hasn't had to take public stands on health-related issues, and he's focusing his campaign on job-training programs he initiated. One, called Georgia Work$, has gained national attention recently, and that's what he prefers to talk about.
Isakson, though, has long been in the middle of the health-reform debate as a member of the Senate Committee on Health, Education, Labor & Pensions. Last fall, Republican officials chose him to deliver the party's weekly address, one attacking President Barack Obama's health proposals.
Republicans have an alternative approach, he explained.
"Republicans believe the key to reforming health care is using choice, by strengthening the doctor-patient relationship, and competition rather than rationing and restrictions to contain costs," he said.
He is a cosponsor of the GOP alternative, the Patients' Choice Act, which would allow individuals to deduct their premiums while making employer-paid plans a taxable benefit. It would also shift Medicaid recipients from government coverage to private plans by issuing vouchers for their premiums. If Republicans gain control of Congress, it's the plan they'll try to pass.
Despite being such a team player, Isakson found himself making waves within his own party when Obama cited an Isakson initiative that got included in Democrats' reform bill. Former GOP vice presidential nominee Sarah Palin described it as creating "death panels" that would empower bureaucrats to have the ultimate say over which patients lived or died.
Isakson's idea that House Democrats liked was to pay doctors for meeting with their Medicare patients to talk about how much treatment they would prefer when they were fighting a terminal illness. His comments in a Washington Post interview ruffled some conservatives' feathers.
"How someone could take an end-of-life-directive or a living will as that is nuts," he said in the paper. "You're putting the authority in the individual rather than the government. I don't know how that got so mixed up."