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How Many Lives Does the Public Option Have?

I'm a longtime, enthusiastic fan of the public option. And I am really nervous about its latest rise from the grave.

As you may recall, the public option died in December, after Senate Majority Leader Harry Reid dropped it from his reform bill in order to secure the final votes necessary for a filibuster-proof, 60-member majority. It was actually the second or third time it had died, depending on how you count, but this time it seemed dead for good.

But in one of the many perverse and unexpected twists of this whole saga, reform's near-death experience after the Massachusetts Senate race has brought the public option back to life yet again. Now that the Senate is expected to vote on a series of final amendments to the reform bill using the reconciliation process, in which just a simple majority of 50-plus-one can pass a bill, progressives are pushing the Democrats to include a public option as part of that package.

For the last few weeks, groups such as the Progressive Change Campaign Committee have been waging a grassroots campaign--circulating petitions, organizing calls to Congress, and keeping a whip count. And it didn't seem to be making huge headway early on. The only senators to sign on were liberal stalwarts (like Sherrod Brown and Bernie Sanders) and members worried about tenuous liberal support for their reelection campaigns (like Michael Bennet and Kirsten Gillinbrand).

But on Thursday, the effort picked up support from an unexpected source, one with much bigger legislative clout: Charles Schumer. The petition drive has just 18 senators, even with Schumer. But suddenly the possibility of getting others seems more plausible.

And that's a great thing, in theory. The political the arguments for including a public option are, if anything, even stronger than they were before. Polls indicate that the public doesn't like the health care reform package, or at least what they know about it. But polls also indicate that the public likes the public option. Adding it would, in all likelihood, make the package itself more popular. It would also reenergize liberal activists, many of whom have grown disillusioned with reform's many compromises.

The policy logic remains compelling, too. The recent news of huge rate hikes for individual policies in California makes clear the need for greater cost control and more secure health insurance options. Reform with a public option would be do a better job on both counts.

But is it really possible to pass the public option? That's where I become skeptical. The theory behind this push is that getting 50 votes for a public option is possible because Reid had 58 votes for his bill before Senator Joe Lieberman demanded removal of the public option. But that was in December, before Scott Brown won Ted Kennedy's old Senate seat and the Democrats went into their political tailspin. Since that time, Democrats--particularly more conservative ones--have gotten very skittish.

At this point, it's going to take a herculean effort by President Obama and the leadership to secure fifty votes even for a modest reconciliation bill, one that merely fixes some of the more egregious flaws in the bill the Senate finally passed. Adding a public option--something more conservative Democrats never liked in the first place--will make that task a lot harder. Here's how one Senate leadership aide put it to me on Thursday, following the news about Schumer:

Despite the flurry of press reports, nothing has changed over the last couple of days, except that maybe there are less votes for the public option that there were a few months ago.

Keep in mind, too, that the prospects for a public option aren't much brighter in the House. That chamber approved a public option in November, when it passed its version of health care reform. But that doesn't mean it would do the same thing today. The Massachusetts election scared a lot of House members, too. And, like Reid, House Speaker Nancy Pelosi's toughest task will likely be corralling more conservative Democrats, most of whom never loved the public option in the first place.

It's impossible to be sure about these things, of course. If Obama, Reid, and Pelosi made it their mission in life to pass a public option--and if progressives could organize with the sort of intensity their tea-partying counterparts on the right do--it could all work out.

But, as Ezra Klein noted today, by making the public option part of the conversation again "you're also increasing internal dissension and adding unpredictability into a process that's collapsed into chaos already." If you think--as I do--that reform would constitute a monumental achievement, even without the public option, that's a huge risk to take.

So, yes, adding a public option could produce an even better reform bill. It could also produce no bill at all.

Follow Jonathan Cohn on Twitter: @jcohntnr