A testy 20-minute exchange between two state GOP senators this past week offered a microcosm of the internal struggle playing out within the Republican Party across the country.

The tug-of-war in the GOP is one of rigid ideology versus pragmatism. Some call it a tension between obstructionism and problem-solving.

The subject being debated on the Senate floor is what some have said was the first serious Republican plan to expand Medicaid, the federal program that provides health care benefits to the poor.

Sen. Ryan Silvey, R-Kansas City, proposed a plan revamping management of Missouri’s Medicaid program as well as other structural changes.

The Springfield News Leader reported that Silvey’s proposal, which has not yet been introduced as legislation, would cover individuals up to 100 percent of the federal poverty level through a managed care plan. Individuals between 100 percent and 138 percent would be enrolled in a health care exchange plan — similar to what is found in a bill sponsored by Rep. Noel Torpey, R-Independence.

Silvey’s plan is more expansive than Torpey’s in changing the state’s welfare programs. Under Silvey’s plan, Electronic Benefit Transfer (food stamp) cards would have a photographic ID. Establishments would be required to match the photograph to the purchaser.

In addition, Silvey’s plan imposes a work requirement on food stamp recipients. Individuals would have to offer proof of work status or show that they are seeking work or further education.

Food stamp recipients would be required to report any instances in which their monthly gross income exceeds the maximum allowed for their household size and would have to undergo a recertification process each year.

Silvey’s proposal was billed as a way to achieve some entitlement reforms and still provide insurance for an estimated 300,000 adults who are not eligible under Missouri’s current Medicaid program.

John Lamping, R-St. Louis, didn’t see it that way. To Lamping, the plan appeared to be a concession to ObamaCare. “It’s time to take the hard stand and say ‘No.’ You’re taking the pragmatic stand, the easy stand,” an agitated Lamping said to Silvey.

That set off a heated exchange between the two conservative lawmakers which made many Republicans uncomfortable.

“It’s easy? It’s easy for me to stand up in the Republican Party with people like yourself who would rather talk about sound bites and ObamaCare than the actual problems ObamaCare has created? It’s easier for me to do that than it is to stand with you and never get into the issue?” Silvey fired back.

“Where we are today is a political quagmire,” said Silvey, “You have people who are more interested in sound bites and more interested in obstructing then they are in realizing what the reality of the situation is and dealing with it.”

Silvey had previously accused lawmakers of “a dereliction of duty” for refusing to deal with big problems, such as “a doughnut hole of several hundred thousand Missourians” who earn too little to qualify for Missouri’s Medicaid program but too much to qualify for federally subsidized insurance policies, according to the Associated Press.

Silvey is right. For too long Republicans have been content to be the party of “no” without offering alternative or competing solutions. They have clung to obstructionism like a security blanket.

There is no better example than in the area of health care. It’s easy to be opposed to ObamaCare. It is not a perfect bill even though it is predicated on many free-market principles previously advocated by Republicans. It is costly and, in many respects, unfair. For instance, it created the coverage gap at the heart of the dispute between Silvey and Lamping.

But it is the law of the land and it is not going away. Sometimes you have to play the cards you are dealt.

As distasteful as it may be, Silvey is trying to make it work in Missouri. Republicans should follow his lead.

However justified, frustration is not a workable political platform. Just saying “No” is not a winning agenda and inaction on this issue is just not smart.