Note/update: A White House official denies that Emanuel has been floating any specific proposal. Says the official: “Rahm continues to speak with members and hear their thoughts, but has not been pushing or advocating one position over another.”

Politico reports that, in an effort to rescue what he can of the Obama Administration’s health care initiative, White House Chief of Staff Rahm Emanuel is floating a proposal “to pass a scaled-down bill that would focus on insurance reforms and some expansion of coverage.”

This, I’m assuming, is the same Rahm Emanuel who, in an interview with a group of reporters last July, reflected on what happened the last time Congress did something like that. “I remember all the high-fiving each other for the portable health care in ’96. It’s been empty,” Emanuel recalled, adding ruefully: “Everybody was high-fiving each other….but the portable health care bill in ’96 didn’t do anything, very little.“

Back in 1996, Emanuel was a top aide in the Clinton White House, which had attempted and failed at major health reform in 1994. So health reform advocates, led by Senators Edward Kennedy and Nancy Kassebaum, came back with an incremental measure, which became the Health Insurance Portability and Accountability Act. It was hailed as a major step toward ending the insurance industry’s ability to deny coverage to sick people. It was supposed to make it easy for people to take their insurance with them when they left a job. These days, pretty much the only effect you see from it is that annoying form your doctor makes you sign saying you understand your privacy rights.

So why didn’t it work the way it was supposed to? For the same reason that other piecemeal reforms haven’t.