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Will The House Kill Health Care Reform?

Historians will tell you that the Senate is where health care reform, like most sweeping pieces of liberal legislation, goes to die. But will this year's health care graveyard be in the House?

A statement by a top House member on Sunday raised that possibility--although several senior staff are now saying the member was speaking on his own and that, contrary to appearances, major health legislation is in the works.

The comment came from Representative James Clyburn of South Carolina, the House Majority Whip, during an appearance on C-Span's "Newsmakers." According to the HIll, Clyburn said that he didn't expect Congress to approve legislation in 2009:

If you take what we've done with [the State Children's Health Insurance Program bill] and then you follow with [more spending] on community health centers, you would have gone a long way to building a foundation upon which to build a universal access healthcare program. ...

I would much rather see it done that way, incrementally, than to go out and just bite something you can't chew. We've been down that road. I still remember 1994 [when the Clinton health care plan failed].

While President Obama and key Senate leaders have indicated via action and statment that they want to enact comprehensive health reform sometime in the next year, the House leadership has been strangely silent, saying virtually nothing about the scope or timing of legislation. That makes Clyburn's statement a potentially ominous sign for reform.

But according to several senior House staff members, Clyburn was just speaking for himself. While acknowledging that many representatives are skittish about reform--in no small part because they, too, fear another epic failure--they all said support for comprehensive reform is building. One senior staffer told me that "the Speaker expects we will do a major health care bill this year"; another said that "we hope to do major steps on coverage by end of this year." For whatever it is worth, Clyburn spokesperson Kristie Greco confirmed that the congressman was speaking for himself.

Of course, "major" is a pretty fuzzy term. And if Clyburn's skepticism is sufficiently prevalent, major reform could still end up meaning something relatively incremental--i.e., legislsation wouldn't really guarantee coverage to everybody, although it might still help a lot of people.

Still, for proponents of reform, news that Pelosi and other senior memers expect legislation this year is an encouraging sign--although a lot will depend on how much political pressure those proponents can generate in the next few months.

--Jonathan Cohn