Sure thing, where to begin.
First, lets be open and honest. The BS about it being the "essentially" the same basically came from people parroting articles that referenced the Kaiser Health News comparison chart. So lets look at that chart.
To begin with, the chart is essentially summarizes and bullet points. Notions like "reduce medicare spending" and "create more efficiency" are INCREDIBLY vauge with KHN giving ZERO extra information concerning the difference there. To simply suggest that both plans wanting to create more efficiency in health care equals having the same plan of reform is ridiculous. You could point to two different plans by Democrats and Republicans concerning say Welfare Reform, saying both want to reform it, and have entirely different things. So the notion right off of using a bullet point chart as "evidence" of the similarities is flawed in and of itself.
But even looking at that list you still have differences. Such as the current law mandating that businesses help pay for premiums for some employees where as the 1993 plan not requiring it. The 1993 plan had malpractice reform, a big thing for republicans, this one didn't. 1993's didn't make 26 year olds children "dependents". 1993 took steps to equalize the taxes for those that are self employed. This plan bans lifetime spending caps, 1993's doesnt. And those are just some of the ones they vaguely note. That's not getting into the fact that they cover HUGE swatches of things with a simple "yes" that to TRULY get a feel for if its similar or not one would need to read both bills in full.
Then lets go deeper. The current bill has a large medicare expansion that could potentially end up covering more people through its expansion, due to the amount of uninsured that would fall under the 133 percent poverty line, than through any other provision. This is a rather substantial thing in and of itself, and is something completely missing from the 1993 bill. The current Bill puts greater taxes on very expensive plans where as 1993 had a tax cap. Again, another large issue for Republicans.
Then you have the misrepresentation by people through implication that somehow this shows that Republicans are moving to the right or becoming more extreme, acting as if this was a majorly touted and supported plan by Republicans. In reality, it was a plan that rapidly lost support. The CBO wasn't scoring things as quickly or continually as it does not, so it took longer for the cost of things to truly come out. However once you did even big named proponents of the bill, such as Bob Dole, quickly moved away from it due to the cost of attempting that much coverage being unfeasable. The attempts at "moderating" and "bipartisanship" put too much bloat into the bill for the cost to be reasonable and it killed support by republicans in the long run. Not to mention it was just one of a number of health care proposals supported by republicans, such as the Packwood Dole one, none of which truly gained exceeding, long lasting party support as more information and facts came out about it.
Now, with all that in mind, there's the notion of history. Republicans pushing for health care plans when the entire government is filled with Democrats generally aren't going to work. If they push what they want, obviously it won't get passed. If they push a compromised or moderate bill, such as the 1993 bill, then it is still in their minds a negative for the country due to the expense of the matter and thus something that quickly lost support. So if you're not going to be able to pass what you want, and you aren't happy and can't fully support a compromised bill which in the end will cause it not to pass as well, in the future which are you going to do? Again compromise on your principles for something that's unlikely to pass if you do it and put your vote behind something you think is going to be broken, or realize that either way you're ideas aren't going to really get done or that what you think will hurt the country will happen so you may as well put forth a proposal you actually feel is GOOD and fits your principles.
Could you show me how they are "essentially" the same Bill besides taking VERY broad categories and statements and simply saying both touched on those things in some way shape or form and thus are similar?