Correction Appended

In an ironic twist of political fate, the precarious state of Sen. Edward Kennedy’s (D-Mass.) health has transformed President-elect Barack Obama’s plan to reform national health care into a legacy project capping a nearly 50-year Senate career.

Senators on both sides of the aisle as well as operatives on K Street were candid that Kennedy’s half-century push for universal health care could receive a boost because of his brain cancer diagnosis and the accompanying understanding that his days in the Senate could be limited. Capitol Hill veterans believe comprehensive health care legislation — with Kennedy at the wheel — is in its best position yet to advance.

“Having him there gives this a sense of urgency. And, they appreciate what an effort he’s making personally — with his own health struggles — to be there, and that has value to it,” said Sen. Chris Dodd (D-Conn.), Kennedy’s closest Senate ally.

Last week, Kennedy could be seen hard at work in the Health, Education, Labor and Pensions Committee chairing confirmation hearings for Obama’s incoming Cabinet. Kennedy ran the panel with his usual efficiency, intermittently conferring with Dodd — who sits next to him on the dais — while exhibiting the vigor of an individual in good health.

Kennedy’s office declined to comment for this story.

Though ideologically liberal and a popular figure in Republican campaign ads seeking to paint Democratic candidates as extreme leftists, the 76-year-old Kennedy has spent his career as the consummate deal-maker. Now in his ninth term, Kennedy — at least since he lost his bid for the Democratic presidential nomination in 1980 — has been at the center of negotiations for nearly every major piece of legislation to come before the Senate.

Sen. Orrin Hatch (R-Utah), among the Senate’s more conservative Members and an across-the-aisle friend of Kennedy’s, said Republican support for health care reform, and Obama’s agenda generally, is possible. Hatch cited Kennedy as the reason for that belief, while noting that bipartisanship on health care and other big-ticket legislation hinges on the Massachusetts Democrat’s ability to rein in his fellow liberals.

Hatch referred to Kennedy as “the leading liberal in the whole Congress,” but also called him a Senator who is “open to compromise, and open to putting things together in a way that can bring both sides together.”

Democrats have been pushing for taxpayer-funded, universal health care since at least President Harry Truman’s tenure in the White House (he left office in 1953).

Kennedy’s overall legislative record includes more than 2,500 bills authored, with several hundred becoming law.

On health care, Kennedy has played a role in the creation of the State Children’s Health Insurance Program, the Ryan White Comprehensive AIDS Resources Emergency Act and the Consolidated Omnibus Budget Reconciliation Act, which allows a company’s former employee to continue receiving health insurance for a fee.

In 1993, the last time Democrats controlled Congress and the White House, Kennedy failed in his bid to enact government-run health care that covers all Americans. But this time around, the prospects are high for Congressional approval of a bill mandating at least some form of universal coverage.

One K Street Democrat who is a veteran of Capitol Hill said Kennedy’s brain cancer, combined with Obama’s ambitious health care agenda and a national economy considered to be in free fall, have created a confluence of events that could lead to the Massachusetts Senator’s long sought after goal of universal coverage.

Two years ago, when the economy was in better shape, a Kennedy in poor health would not have been enough to undo the legislative logjam that has long characterized this complicated and controversial issue, according to this Democratic operative.

But many other K Street players — both Democrats and Republicans, including those with lengthy Capitol Hill résumés — said Kennedy is the reason a bill is likely to pass this go-around. Those interviewed for this story responded gingerly to the question of whether Kennedy personally views this latest stab at health care legislation as a legacy bill, although that seems to be the consensus view in Washington.

“The entire Democratic caucus and even some in the Republican caucus know it’s the final thing for Kennedy, and they want to get it done and put his imprimatur on it,” said a former Senate Democratic aide who now works downtown. “They’ll probably put his name on it.”

Kennedy was diagnosed with brain cancer last May and given a dire prognosis. But in late August he attended the Democratic National Convention in Denver and delivered a keynote speech to the delegates, vowing to return to the Senate to help support the enactment of Obama’s agenda.

Kennedy’s endorsement of Obama early on in the crowded 2008 Democratic presidential primary campaign — and of his niece Caroline Kennedy’s (D) decision to seek New York Gov. David Paterson’s (D) appointment to replace Sen. Hillary Rodham Clinton (D-N.Y.) — have been viewed as legacy-building moves on the part of the Massachusetts Democrat.

But implementing a major health care overhaul could be the pinnacle of a career that, in terms of passing legislation, could prove to be among the most productive and influential in the chamber’s history. Considering Kennedy’s illness, some in Washington believe Kennedy recognizes this, and would not have rushed back to Capitol Hill had Obama not won the presidential election.

In fact, in the days and weeks since the November election, Kennedy, his staff, and his K Street allies started quietly and methodically working on health care reform. Many believe whatever Kennedy comes up with will serve as the primary legislative vehicle for comprehensive health reform in the 111th Congress.

Kennedy’s cancer notwithstanding, passing legislation with a “universal coverage” label faces significant hurdles. Working in Kennedy’s favor are Obama, the enormous hunger for such a bill in the health care community and the Senator himself.

Working against Kennedy are an array of interests opposed to taxpayer-funded, universal health coverage and their Republican allies in the Senate, who maintain considerable power despite the minority party’s diminished standing.

Kennedy’s battle with cancer may add extra juice toward hammering out legislation and bridging the gap that divides both sides of the health care debate. But one veteran GOP lobbyist argued that it’s not enough to solve one of the nation’s longest-running legislative disputes in the last 100 years.

Senate Republican Conference Chairman Lamar Alexander (Tenn.) acknowledged as much on Friday, minutes after leaving a HELP Committee confirmation hearing. Alexander is another of the GOP Senators who has a close, working relationship — and warm affection for — Kennedy.

“It all depends on Sen. Kennedy’s attitude,” Alexander said. “Most Republicans don’t favor a single-payer system. We want individuals to have health insurance, but we want them to be able to choose their policy and choose their doctor. So if Sen. Kennedy were not to agree to any of that, that wouldn’t help create a bipartisan result.”

Those familiar divisions notwithstanding, Republicans and Democrats alike acknowledge no bridge will be built on health care reform without Kennedy in the room.

“If there’s one person identified with health care in the Congress, it’s Ted Kennedy,” Sen. Tom Harkin (D-Iowa) said. “Let’s be frank about it, because of his condition, we want to get it done, and we want to get it done with him in the chair.”

Correction: Jan. 13, 2008

The article misspelled Caroline Kennedy’s first name.