With the health care reform debate in full tilt, it’s fair to assume that the Senate Health, Education, Labor and Pensions Committee is the key player in producing the final version of the Senate’s package.

But with HELP Chairman Edward Kennedy (D-Mass.) largely absent because of his battle with brain cancer, it’s not business as usual at the committee.

The HELP Committee has certainly played a role in health care reform, but it has largely been a staff-driven process, according to health care lobbyists.

“The biggest problem with what’s happened with the committee, what it’s really sort of illuminated, is how incredibly important Kennedy as a person was to the accomplishments of the committee,— one Democratic lobbyist said.

For the past year and a half, Kennedy’s staff met with health care stakeholders to come up with HELP’s proposal. But after HELP came forward with its legislative product, several of the people in those meetings felt as though the committee had not listened to their concerns at all and came out with the same proposal that it would have if the meetings never occurred, lobbyists said.

Sen. Chris Dodd (D-Conn.) has emerged as acting chairman of the committee and has tried to corral the process, but the bill that has emerged is more of a goal post and not close to what is likely to be the final legislative product, health care lobbyists say.

“Kennedy is sorely missed,— one veteran health care lobbyist said. “He knows how to cut deals with his colleagues and Republicans, and if he was here and in good health, he would be the dominant player in the whole Congress on health care.—

Without Kennedy, lobbyists said, Dodd is doing the best he can, but Kennedy’s absence has created a mismatch between HELP and the Finance Committee, the other Senate committee developing health care legislation. Dodd is still chairman of the Banking, Housing and Urban Affairs Committee, which continues to deal with the meltdown of the financial system and President Barack Obama’s plan for overhauling the regulatory system. On top of these pressing issues, Dodd is facing a tough re-election race in 2010.

Still, health care lobbyists said ignoring the committee and Dodd is a mistake.

As the Senate Finance Committee and the HELP Committee look to reconcile their packages, Dodd is likely to emerge as a key deal-maker. “If you are smart, you will know he is one of a small handful of Senators making the important decisions at the end,— said Rich Tarplin, a former Dodd staffer now at Tarplin Strategies.

Dodd has also taken the reins on trying to get a deal regarding the three major health care issues that are still being negotiated in the reform debate — whether it will include a public insurance plan, language on biologics and an employee mandate.

Follow-on biologics are generic products that are marketed after the expiration of a patent that have a similar, but not identical, makeup of existing biologic products.

Proponents of including biologics in health care reform say Dodd has recently started to take a much more active role on the issue.

“Biologics may be the single most important policy in health care being debated, second only to health reform, and its inclusion to me would seem to be a no-brainer,— said Missy Jenkins of Belleaire Consulting. Jenkins counts the Pharmaceutical Care Management Association as a client. PCMA is a large advocate of biologics.

Health care advocates are eagerly awaiting the committee’s release of the public plan and biologics. “One of the reasons you haven’t seen it is, I’m sure he’s trying to make sure the release of those things doesn’t start another wave of criticism like the public plan,— a health care consultant said.

K Streeters are also closely watching what parts of health care reform may be stripped from the package if a bipartisan agreement cannot be reached. If Finance Chairman Max Baucus (D-Mont.) ends up using reconciliation to get health care reform through the Senate, there are likely to be several parts of the bill that could get stripped.

With the committee’s full attention on the massive health care reform, other priorities, including a cancer bill that has long been a priority of Kennedy’s, have gotten pushed back. Kennedy’s bill would give more money to groups like the National Cancer Institute and also try to improve coordination of all stages of treating cancer.

“Health care [reform] is just sucking all the air out of the room,— the consultant said.