A Quick Look at the House Vote On Health Care: Who Defected?

Most of you woke up to the news that the Democrat-controlled House passed a health care bill last night on an almost straight party line vote, 220-215.  Only one Republican voted with 219 Democrats to support the bill, while 39 Democrats joined with 176 Republicans to oppose it.  The almost unanimous Republican opposition surprised no one, since they have signaled from the start of the House debate that they could not support the basic framework of the majority party bill.  What was more interesting, however, was the opposition from the Democrats, because it foreshadows the difficulties the bill is likely to face in the Senate.  With that in mind, I took a quick look at who, among the Democrats, opposed their leadership.  The results are a reminder that we are governed by a geographically-based congressional system – not a presidential one, and that members of Congress are acutely responsive to local electoral forces.

Here is a table listing the 39 Democrats who bucked their own leadership to vote against the House bill. In the last column I list whether their vote against the House health care bill could be predicted based on whether their district went for McCain in 2008.  This is a crude measure of district sentiment, but as you’ll see it does provide some analytic leverage.

Representative State -District McCain Vote in 2008 (% of total vote) Obama  Vote Did Representative Vote with district sentiment based on Presidential Vote in 2008?
Adler NJ 3 47 52 NO
Altmire PA 4 55 44 YES
Baird WA 3 46 52 NO
Barrow GA 12 45 54 NO
Boccieri OH 16 50 48 YES
Boren OK 2 66 34 YES
Boucher VA 9 59 40 YES
Boyd FL 2 54 45 YES
Bright AL 2 63 36 YES
Chandler KY 6 55 43 YES
Childers MS 1 62 38 YES
Davis AL 7 27 72 NO
Davis TN 4 64 34 YES
Edwards TX 17 67 32 YES
Gordon TN 6 62 37 YES
Griffith AL 5 61 38 YES
Herseth Sandlin SD (all) 53 45 YES
Holden PA 17 51 48 YES
Kissell NC 8 47 53 NO
Kosmas FL 24 51 49 YES
Kratovil MD 1 58 40 YES
Kucinich OH 10 39 59 NO
Markey CO 4 50 49 YES
Marshall GA 8 56 43 YES
Massa NY 29 51 48 YES
Matheson UT 2 57 39 YES
McIntyre NC 7 52 47 YES
McMahon NY 13 51 49 YES
Melancon LA 3 61 37 YES
Minnick ID 1 62 36 YES
Murphy CT 5 42 56 NO
Nye VA 2 49 51 NO
Peterson MN 7 50 47 YES
Ross AR 4 58 39 YES
Shuler NC 11 52 47 YES
Skelton MO 4 61 38 YES
Tanner TN 8 56 43 YES
Taylor MS 4 68 32 YES
Teague MN 2 50 49 YES

We see that 31 of the 39 Democrats (those in bold-face type) who voted against the health bill represent districts that supported McCain over Obama in the 2008 presidential election.  This includes many first-term Democrats who barely won in districts that historically tend to vote Republican. (Keep in mind that a few of the Democrats opposing the bill did so because they felt it wasn’t progressive enough.)  To put it another way, there were 48 districts, by my count, that split their ticket in 2008 by voting a Democrat in as representative but who supported McCain over Obama in the presidential election.  Only 17 of those Democrats felt comfortable voting for health care reform.

This is why it is so difficult for presidents to exercise any leverage within Congress on key votes like health care reform.  Although congressional races have become increasingly nationalized in recent years, it is still the case that representatives respond largely to district-level factors. Unlike their counterparts in parliamentary systems, presidents cannot call for new elections when they lose a crucial vote, and they must rely on the party leadership to rally votes on their behalf.

To put this in perspective, consider this: the Democrats control the House by an 81-seat majority, 258-177.  And yet on the most critical vote the party leadership is likely to face during the entire congressional session, they lost 39 members and were only able to pass the bill by five votes.  And it is almost certainly the case that this legislation will not survive a conference with the Senate in this form.

I’ll have more to say on the House vote and likely Senate deliberations in a later post, but I wanted to use this vote to remind you, once again, just how limited a president’s power is in our system.

(After painstakingly constructing this table, I see the NY Times has a much more detailed chart here.  That’s what I get for going to the roll call listing first!)


  1. The one major outlier is Artur Davis of Alabama who is running for Governor, which may help explain his vote.

  2. David – I hadn’t realized Davis was running for Governor. I believe he was unopposed in 2008, and so I suspect he was something of a free agent regarding how he voted. My read was that he thought the bill wasn’t progressive enough – that’s why Kucinich voted against it. But you may be right – it may be Davis positioning himself for a statewide run.

    Note that the lone Republican to vote for the Democratic health bill is from Louisiana and was elected only because of the scandal that drove William Jefferson, the previous Democratic representative, to defeat.

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