Obamacare

Mexicans and Medicine: A Grand Bargain?

What if Republicans decide they dislike Mexicans less than they despise Obamacare, and Democrats realize immigration liberalization is more attractive than illusory healthcare "reform"?

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If politics is the art of the possible, it's at least plausible that reasonable conservatives and moderate liberals might reach a grand bargain taming the two big policy beasts: immigration and healthcare.

That could happen if Tea Party Republicans decide they dislike Mexicans less than they despise the Affordable Care Act (ACA.) And it would require enough scared moderate liberal Democrats to realize immigration liberalization is more attractive to swing voters than illusory healthcare "reform."

Deserting the ACA recently to support the GOP's keep-your-current-insurance plan, about 40 House Democrats facing close 2014 contests understood that legislation they rammed down throats of every single GOP legislator in 2010 is once again the albatross it was when Republicans seized the House that year.

Democrats facing up to unintended consequences of the ACA may dodge ballot bullets next year, from independents concluding ObamaCare is a Rube Goldberg contraption, benefitting BigPharma and BigInsurance, without cutting costs or achieving wellness.

If Democrats agree to re-litigate healthcare and focus on just a few problems, like pre-existing conditions and catastrophic medical bills, it's possible House Republicans can forego dreams of building a Berlin border wall and deporting Mexicans in numbers equal to about half the population of Texas.

Immigration reform supported by enough House Republicans could yield a real legacy for President Obama, similar to Bill Clinton's claiming Republican-enacted welfare reform as his legacy post-HillaryCare. But it would also benefit Republicans. Cooler-headed strategists understand Hispanic antipathy can doom GOP presidential ambitions for years. Older Latinos may be Democratic, but as new generations become middle class, Republicans have a shot at their support—if they can get past strident nativism.

On both issues, Democrats and Republicans are captives of policy-by-anecdote. Tea Partiers envision Mexicans crossing the border with pounds of marijuana in backpacks, lining up for welfare checks in El Paso. Lefty Democrats recount atypical horrors of single mothers bankrupted by medical bills, dreaming of doctors on the public payroll. Political reality lies beyond those scare tactics for keeping Mexicans out and forcing single (government) payer in.

As Michael Barone points out in Shaping Our Nation: How Surges of Migration Transformed America and Its Politics, the net influx of illegals ended in 2007, as the housing market collapsed and the Great Recession began. Now we're seeing Americans retire in Mexico.

Liberal mantras about "hard-working middle class Americans without healthcare" are from the play book of campaign consultants who began selling "reform" as a winning Democratic issue vehicle back in 1991, when hired guns James Carville and Paul Begala pulled Sen. Harris Wofford out of a downward spiral and had him ride to victory on an amorphous healthcare "reform" platform. The two pedaled the tonic to the Clintons in 1992, which begat HillaryCare, which ended up giving the GOP control of the House in 1994.

Certainly there have been illegal Mexicans immigrants who gamed the system. And we can always find emotional hardship anecdotes from America's "failed healthcare system," more compelling than the truth that wellness is hindered by morbid obesity and couch potato lifestyles.

We're not returning to a 19th Century open door policy for the tired, the poor and the huddled masses. And we're never going to enact 100 percent government-run medicine.

But the art of the possible could produce a win-win for both parties if less strident voices see an intelligent way forward on both immigration and healthcare.