Let's take a look at the breakdown of the vote on the health care bill -- the people who went against their leadership, or the people whose votes run seemingly counter to their districts' presidential votes in 2008 -- and in some cases, both.
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Much has been made of the Democrats who voted no, and the fact that most of them come from districts that voted for John McCain. Thus, a vote against a major Obama policy initiative would certainly seem to be the safe thing to do -- just as Rep. Joseph Cao (R-LA) became the only Republican to vote yes, and his district voted 75% for Obama.
The single largest group, however, is one that hasn't been commented on very much: Republicans from districts that voted for Obama, and who voted no on the bill. There are 32 of them in all: Judy Biggert (IL); Brian Bilbray (CA); Mary Bono Mack (CA); Ken Calvert (CA); Dave Camp (MI); John Campbell (CA); Mike Castle (DE), currently a Senate candidate in an Obama state; Charlie Dent (PA); David Dreier (CA); Randy Forbes (VA); Elton Gallegly (CA); Jim Gerlach (PA); a candidate for governor in an Obama state; Mark Kirk (IL), a Senate candidate in Obama's home state; Leonard Lance (NJ); Tom Latham (IA), Frank LoBiondo (NJ), Dan Lungren (CA), Donald Manzullo (IL); Thaddeus McCotter (MI); Buck McKeon (CA); Erik Paulsen (MN); Tom Petri (WI); Dave Reichert (WA); Mike Rogers (MI); Peter Roskam (IL); Ileana Ros-Lehtinen (FL); Paul Ryan (WI); Lee Terry (NE); Patrick Tiberi (OH); Fred Upton (MI); Frank Wolf (VA); and Bill Young (FL).