In stark contrast to recent reports of a deal that would pass comprehensive health care reform, Rep. Eric Massa (D-NY) told supporters this week that a comprehensive bill would not pass, and the best alternative option would be to get Republicans on the record with a series of smaller bills, building incrementally to a full set of reforms. Massa said that the House would begin that next week, when they finally take up the delayed (by snow) vote to repeal the insurance industry’s anti-trust exemption.

Massa didn’t vote for the House bill, being focused entirely on a single payer solution. This has been his position since well before being elected to office in 2008, and he has never wavered from it. I wasn’t aware of the history leading him to that decision. Massa was diagnosed with non-Hodgkin’s lymphoma and given four months to live. That was eleven years ago. “I’m alive because of the best experimental medicine in the world,” Massa said. “Why millions of our own citizens don’t have the same opportunity is a tragedy. My religion teaches me that it’s fundamentally immoral to profit off of people’s medical care.”

The New York Democrat simply said that the Senate bill can never pass the House of Representatives, even with fixes through reconciliation. He certainly committed himself not to vote for it, and he was one of the several No votes that the House leadership may have hoped to flip into the Yes column. His major contention seemed to be that the House would have to pass the Senate bill before changes were made, which isn’t necessarily true. But regardless, he wouldn’t commit to that passage. “It doesn’t have a public option,” Massa said. Asked why he then voted against the House bill, which did have one, he explained that it would have only been available to 2% of the population. “Wouldn’t you rather accept half a loaf,” someone asked. “Yes, if the half a loaf isn’t laced with cyanide,” he replied.

However, Massa added that “from great defeat comes great victory,” and he called for splitting health care into discrete parts, forcing the opposition to vote on popular elements and putting them on the record. The first of those votes will come next week on the anti-trust exemption. Massa wants future votes on popular provisions like banning the denial of coverage based on pre-existing conditions. Told by a supporter that it would be potentially more harmful to ban that provision without a mandate or community rating because insurers would simply price anyone with a pre-existing condition out of the market, Massa said he knew, but that politically this was the only way forward.

Previously, Massa has endorsed a three-track approach, with the small-bill approach being one track. Next, he would work to organize in states will single payer could gain support, and fight for passage there. “Success in even one state would be monumental,” he said. Finally, he would support a bill allowing the federal government to fund something like single payer in the states, with incorporation of Medicaid and SCHIP funding into one comprehensive program. “Parallel to this, a bill expanding age eligibility for Medicare is crucial,” he added.

Massa took pains to suggest to the audience, made up of mostly progressives, that he considers himself more of a fiscal conservative, as evidenced by his many votes against cramdown, against the House financial reform bill, for killing the Consumer Financial Protection Agency, etc. But he cited single payer as the most fiscally responsible option possible in health care reform.

Massa faces difficult re-election prospects in a competitive western New York district.