(CNN) – In his new book, "Immigration Wars," former Florida Gov. Jeb Bush backs a controversial proposal that could give states the flexibility to deny some emergency room care to undocumented immigrants.
Bush, in an interview with Jake Tapper, CNN's chief Washington correspondent and anchor of the upcoming show "The Lead," said he thinks most states would still "want to have that basic care" but added that the nation should at least have a "conversation" on the issue.
While the Emergency Medical Treatment and Active Labor Act requires emergency rooms to treat anyone who comes through the doors, critics argue the law drives up health care costs, saying many undocumented immigrants don't have health insurance and use emergency rooms for primary care.
Bush said that border states "feel completely abandoned by the federal government" on the issue and should have more room to make decisions about who should get what care.
"Local governments pay a pretty significant price in terms of health care costs, education costs, and others," Bush said, adding that states should "play a role in defining the benefits that come with being a resident of the country."
He also favors the idea of allowing local law enforcement to be "the eyes and the ears of the border patrol" in order to "extend the reach of enforcement."
Bush, however, opposed similar laws, such as the controversial measure passed in Arizona, which gave local authorities the right to check an individual's immigration status while enforcing other laws. The provision was upheld by the Supreme Court last year.
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Bush, however, said the measure puts too much burden on local police to do the work of federal authorities. His proposal, he argues, would be in "total cooperation with the federal government." He cited Florida as an example, a state where local authorities can pick someone up but wait for a border patrol agent to takeover from there.
As Bush lays out his immigration policy this week, he's received criticism for flip-flopping. The former governor has said he opposes a pathway to citizenship but could nevertheless support such a pathway if it's proposed by lawmakers this year.
Rep. Xavier Becerra, chairman of the House Democratic Caucus, released a statement in English and Spanish saying, "Poor Jeb Bush. So far from God and so close to the Tea Party...This is why things are the way they are, because Republicans let themselves be bullied by the most extreme members of their party."
Senate Majority Leader Harry Reid also joined in on the criticism Tuesday.
"Let's wait for a few minutes and see how Jeb Bush changes his mind again," Reid said to reporters. "His opinion on immigration is not evolving it is devolving. He keeps going backwards. I think, frankly, he has made a fool of himself the last 24 hours."
Reid said he doesn't think Bush is a "Florida Leader" saying the former governor hasn't been elected to any office recently. Reid instead pointed to Sen. Marco Rubio as the senior Republican voice from Florida and the "leader on immigration."
Rubio is one of eight senators working in a bipartisan group on Capitol Hill to pass immigration reform that includes a pathway to citizenship. With a similar effort underway in the House, the immigration push marks the biggest move towards reform since Congress nearly passed legislation in 2007, during President George W. Bush's administration.
President Barack Obama, meanwhile, has urged Congress to act quickly and pledges to introduce his own bill if lawmakers fail to act. While he hasn't given a strict deadline, the president has said he'd like to see something happen in the first half of the year.
Asked if Bush thinks his positions and perceived flip-flopping will hurt the GOP, Bush said he wrote the book last year, before some top Republicans began supporting a pathway to citizenship.
"The environment (last year) was no immigration reform, period, over and out, and as a frustrated conservative, my thought was how can we create the ideal position that conservatives could embrace to be in the game," he said.
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Bush reflected on his brother's attempt at trying to get an immigration packaged passed on the Hill.
"Man he got to the two yard line before there was a fumble. I mean it was - It passed the House. It had 60 votes in the Senate, you know, the magical number," he said. "And as I understand it both the leadership in both parties kinda gave a pass to the freshman senators that said if this is going to put you in a bad position in your election coming up, which would have been 2008, don't do it. "
The former governor said it could be successful this time if new immigration laws have a stronger economic focus. As of now, he said that a small percentage of immigrants come to the country for economy opportunities, whereas many more come to be with family. In Canada, he argued, the number of those seeking jobs is closer to 80%.
To make that shift, he proposes another controversial measure, which is to narrow the number of family members who can be petitioned to come to the country. He wants the law to only allow spouses or children, rather than extended family such as cousins and grandparents.
"We're the only country that has this broad definition of family reunification," he said. "And then that effect is we have what's called chain migration."
Bush said the proposal may be considered "provocative" and "controversial" but he insisted it's "the best approach."
"There are people that would love to come to this country that don't have relatives here that could make an immediate contribution and is it– is it wrong for our country to have a strategic approach to immigration? I don't think so," he said.
Bush acknowledged that the Republican Party was shifting on its tone regarding immigration but cautioned that "this is one of the most complex issues that the Congress has to deal with."
"So it's going to require a lot of patience on behalf of people that apparently, it looks to me, don't have it," he continued. "I mean we're living in this world of immediate gratification. This is going to take time to work and I think the president would be wise to pull back a little bit, de-politicize it, let people have their conversation."
– CNN's Ashley Killough, Kevin Liptak, and Deirdre Walsh contributed to this report.