At the beginning of this year’s health care reform effort, pundits and the prognosticators alike considered Senate Minority Leader Mitch McConnell (R-Ky.) and his 40-member Conference inconsequential to the health care reform debate. But McConnell is still kicking.

The Kentucky Republican has managed to hold his Conference together on health care reform in the face of a popular new Democratic president and a 60-seat Democratic Senate majority. Even at the height of President Barack Obama’s high approval ratings, Republicans largely stuck to their guns on health care policy.

Thus far, only one Republican Senator, moderate Olympia Snowe (Maine), has voted for a Democratic health care bill. And since her vote in favor of the Finance Committee’s health care package, Snowe has become a “nay— vote, deciding she doesn’t like what Majority Leader Harry Reid (D-Nev.) is about to roll out. Reid has said he will push a bill that contains a public insurance option with an opt-out provision for the states.

McConnell has been much ridiculed for delivering more than 50 speeches on the floor saying essentially the same thing, day after day, on the policy and politics of health care. But over the course of this repetitious exercise, McConnell has helped frame his party’s message and set the tone for the broader opposition to the Democratic health care plans. McConnell is expected to continue to play a central role as the Senate bill moves forward, leading Conference efforts to slow the measure down or filibuster key aspects of the Democratic plan. If the bill fails to pass, McConnell is likely to be credited or blamed for its failure.