NARROWING THE OPTIONS…. The need for health care reform hasn’t changed, the political calculus obvious has. With a Coakley victory in Massachusetts, the landmark legislation was a near-certainty. In the wake of Brown’s victory, the once-in-a-generation opportunity is hanging by a thread.

As policymakers began to realize over the last week or so that Massachusetts was moving in the wrong direction, a variety of backup plans were considered. One possibility was wrapping up the negotiations on combining the House and Senate bills, and approving the bill before Brown takes office.

That option, which was a long shot anyway, was quickly taken off the table last night.

Less than 15 minutes after the race was called for Republican Scott Brown, the first of what could be many conservative Democrats asks for leadership to put the brakes on health care reform.

Sen. Jim Webb (D-VA) congratulated Brown on his win and delivered a zinger: “…I believe it would only be fair and prudent that we suspend further votes on health care legislation until Senator-elect Brown is seated.”

Indeed, the very idea of the Senate approving any health care bill anytime soon seems largely impossible. Proponents would still need 60 votes in the face of Republican obstructionism. The Democratic caucus is down to 59, and there’s evidence that several of those 59 aren’t prepared to support a reform bill if it comes back to the chamber. Joe Lieberman, for example, is already distancing himself from the bill he helped make worse. Somehow convincing Olympia Snowe, in other words, is no longer good enough.

Another option, preferred by some progressive activists, is to literally start over in both chambers, pursuing a more ambitious reform through reconciliation. This seemed exceedingly unlikely before the special election in Massachusetts, and the odds are far worse now. Lawmakers are ready to move on to other issues, not spend the next few months on a new bill.

Which brings us back to the most obvious, most direct, and most promising avenue: the House approves the Senate bill, and sends it to the president for his signature. Democratic leaders in the House still hold out hope that this is a viable alternative — especially when additional improvements to the bill can be made through the upcoming budget reconciliation process.

The question is whether rank-and-file House Dems have the stomach for it. As of right now, they appear ready to throw in the towel and accept defeat. “If it comes down to that Senate bill or nothing, I think we’re going to end up with nothing, because I don’t hear a lot of support on our side for that bill,” Rep. Stephen Lynch (D-Mass.) said.

The NYT added a similar assessment, reporting that “the prospect of passing the health care overhaul by pushing the Senate plan through the House appeared to significantly diminish.”

To be sure, it’s early. The results in Massachusetts were called 12 hours ago, and the dust has not yet settled. The political world will catch its breath, take a closer look at its options, and decide how (and whether) to proceed.

But if the House rejects the most promising path — pass the Senate bill, make improvements through reconciliation — they’re making a devastating mistake and risking electoral suicide. More on this later.

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Follow Steve on Twitter @stevebenen. Steve Benen is a producer at MSNBC's The Rachel Maddow Show. He was the principal contributor to the Washington Monthly's Political Animal blog from August 2008 until January 2012.