Judd Gregg: Return of the adults

Has the heyday of hysterical hyperbole ended?  

Is Steve Bannon on the wane? 

Have Sen. Ted Cruz’s (R-Texas) Republican colleagues tired of the marginalization he brings forth? 

{mosads}Is the policy of never voting for anything that could pass, as espoused by Sen. Rand Paul (R-Ky.), becoming passé? 

Have even the socialist diatribes of Sen. Elizabeth Warren (D-Mass.) rendered her less resonant?

Who knows? But at least it now seems as if there is some hope that the adults have decided to get back in the game. 

As a result, the American people may actually get what they want and need: a government that governs for their benefit and wellbeing.

The recent agreement between Sen. Lamar Alexander (R-Tenn.) and Sen. Patty Murray (D-Wash.), which was initially endorsed by President Trump, is a light in the wilderness of congressional dysfunction.

Hardliners of right and left of course complain about this agreement.  

To conservatives, the fact that it is not an outright repeal of ObamaCare, and indeed continues the subsidies of insurance policies that cover people who are in the exchanges, reflects capitulation to the Democrats.

This is true, in part.

But what is also true is that the subsidies of insurance coverage that benefit many Americans are difficult to withdraw. If they are simply cancelled, as some conservatives advocate, the savings will be illusory.    

This is because none of the Republican plans — all of which have failed, to date — really puts a dent in the cost attributed to those subsidies. They simply move around the way those subsidies are doled out.  

Whether conservatives like it or not, subsidies once given to large numbers of Americans for anything — whether it is Medicare, social security or in this case basic insurance coverage — are almost never significantly reduced. 

The Democrats understood this when they passed ObamaCare.

Their goal was to add millions of Americans to a subsidized system and hope that, when it failed, “single-payer healthcare” would be the default option.  

Liberals did not plan on President Trump or a Republican Congress.  

But what conservatives must realize is that the American people want their healthcare coverage. They expect it to be affordable, which means for many it must be subsidized.  

The issue is how to better deliver healthcare using the market rather then having the Obama-era top-down government controls. If this is accomplished, then the constantly rising costs of healthcare can be controlled and savings to the federal budget will be made. 

Obtaining this goal is what replacing ObamaCare should be about.

Where conservatives win in the Alexander bill is in changing fundamentally the relationship between the states and the federal government in the control of Medicaid and its delivery — including the opportunity to insert more private sector discipline into the costs that drive the system. 

The agreement gives states significant flexibility to write their own Medicaid programs.  

In Republican-controlled states, at least, freed of federal bureaucratic excess, this will mean more coverage of more people at lower costs, partly through using private sector incentives.

It is a big deal. 

Ironically, the president initially understood this better than those purists of the right who miss the point of governing, which is to get something good done.  

The changes that will come from states controlling their own destiny as they wrestle with delivering healthcare could be significant, constructive, creative and good.

In many states, conservative governors and legislatures, no longer subservient to federal bureaucrats, will show they can deliver a better healthcare system at a more affordable cost. 

It is called federalism. It is what conservatives were sent to Washington to foster.

Let’s hope that this agreement is the beginning of other efforts to move towards a government that works, rather then one that is self-destructive. 

In some cases, this may require the trade-offs that create bipartisan deals.  

Such bipartisanship is of course anathema to many on the left and the right. 

But for Republicans who want to retain control of the government and deliver on major parts of their conservative agenda, the way forward is to govern.   

Sen. Alexander has set out a path to do this. Hopefully it will be taken.

Judd Gregg (R) is a former governor and three-term senator from New Hampshire who served as chairman and ranking member of the Senate Budget Committee, and as ranking member of the Senate Appropriations Foreign Operations subcommittee.