KANNAPOLIS, N.C. -- To voters in this hard-luck town where stable factory jobs and the health care that came with them have long since disappeared, change looked good a year ago. Change came not only from President Obama, who narrowly won this swing state, but also from a millworker-turned-high school civics teacher who had no political experience but ran on a promise to bring a progressive everyman's sensibility to Congress.

Rep. Larry Kissell (D-N.C.) voted against health-care reform even though it is badly needed in the largely rural district he represents. (Jim R. Bounds For The Washington Post)

Fueled by the liberal grass roots, Democrat Larry Kissell stitched together a winning message about jobs and kitchen-table concerns, including rising health insurance costs, and he rode the Obama wave to unseat a five-term GOP congressman by 11 percentage points. Democrats here rejoiced. Finally, they were sending to Washington a representative to fight for their interests -- and to help enact the new president's agenda.

Now, one year later, the euphoria has given way to second thoughts at best and outright rebellion at worst. Kissell is siding with Republicans on Obama's top domestic priority, fixing the nation's health insurance system, and his "no" vote has enraged fellow Democrats.

As they plunge into next year's midterm contests, Republicans and Democrats are making dicey calculations with their health-care votes, each weighing the demands of their party's base against the political climates of their districts. With Republicans opposing the bill in lock step, the White House needs a fragile coalition of Democrats to enact reform, but it is vulnerable Democrats like Kissell who form the greatest obstacle.

And that is why Democrats here are steaming.

"People want change, and when someone puts their foot in the door to kill the whole thing, that's what has them riled up," said Michael Lawson, an African American leader of the state Democratic Party and one of Kissell's constituents. "It's almost like 'Mr. Smith Goes to Washington,' but Mr. Smith turned out to be somebody that wasn't Mr. Smith."

A Medicare promise

When the House passed the Affordable Health Care for America Act on Nov. 7, Kissell was among 39 Democrats who voted no. Like Kissell, many of them are endangered freshmen from traditionally conservative districts, trying to appeal to conservatives and independents.

Still, Kissell's vote is perplexing considering the need for health-care reform here in the largely rural 8th Congressional District. The district, at the heart of the state's weakened textile industry, stretches from Charlotte to Kannapolis to Fayetteville and was shedding manufacturing jobs even before the recession. Now, about 20 percent of residents younger than 65 have no health insurance -- among the highest rates in the nation -- and the bill would provide coverage to about 85,000 who are uninsured, according to a congressional analysis of census data.

Kissell said that he sides with his party on the vast majority of votes and supports expanding coverage, but that he voted against the bill because it would have cut about $399 million from Medicare to find savings. He said he was not willing to renege on his campaign promise never to cut Medicare funding.

"My line in the sand is Medicare," Kissell said in an interview. "One of the things that's missing in people's trust factor is people keeping their word. Whether I win or lose, I've got to look at myself in the mirror the next day, and a word that's important to me is integrity."

Like most members of Congress, he has been deluged with calls, e-mails and letters from constituents, which his office said ran about even through August -- when opponents of the health-care effort became more organized nationwide. Since then, his office said, correspondence from constituents has come in about 2 to 1 against the legislation.

What Kissell considers a principled stand over Medicare, some of his constituents view as a classic Washington betrayal. And his vote threatens to fray the coalition that propelled him to victory. Many Democrats here gave him money and knocked on doors for him because they saw in him a break with the partisanship of Robin Hayes, his Republican predecessor.

In one vote, that sense of possibility was dashed, as many local party leaders said they think Kissell has become transformed by the sometimes dirty business of governing and the compromising quest for reelection.

"They feel betrayed," said June Mabry, chairman of the state Democratic Party's 8th District. "They're not expecting him to be an absolute puppet, but this is a watershed vote for the United States."

Grace Liem, a nurse practitioner at Community Free Clinic, which serves the uninsured in Concord, was an Obama delegate at the Democratic National Convention. "We felt [Kissell] was one of us and could empathize. He's not. You know what's on his plate now? He's concerned about the estate tax. The estate tax! Nobody here has an estate."

Lost faith

In downtown Kannapolis, the historic Cannon Mills plant once stood as the world's largest producer of towels and sheets. But in 2003, its new owner went belly up and about 4,300 employees came to work one day to find the gates locked and their jobs gone. The factory was later demolished to make way for a scientific research campus, but the manufacturing jobs never returned.

On Main Street, across from a furniture store going out of business, Ronald Reynolds displayed plush snowmen and poinsettia bouquets on the shelves of his red-brick Christmas collectibles store and wondered when the help would come. Facing declining sales at Southern Charm, the 44-year-old said he can hardly pay for health insurance anymore. "I can't afford to get sick," Reynolds said. "I would like to see the government health plan. . . . I voted for Obama and Kissell." But, he added, "I've lost faith."

Eve Roberts, a Democratic volunteer from Concord, has been pleading with Kissell to support health-care reform, but she said he does not seem to be listening. Worse, she said, Republicans have been calling the Cabarrus County Democratic Party thanking the congressman for his vote. "It's infuriating," Roberts said.

Five Republicans are vying for Kissell's seat in a district the National Republican Congressional Committee considers a top pickup opportunity. This doesn't seem to faze Kissell. "I have sworn that I'm not going to talk about the next election until a little bit later down the road," he said.

Further complicating his path, some of the liberal bloggers who buzzed about him in his first campaign, in 2006, when he lost to Hayes by 329 votes, and in his 2008 rematch said they are so upset about his health-care vote that they are trying to turn away his potential donors. Local Democratic leaders said they have been meeting in recent weeks to discuss recruiting a more liberal Democrat to take on Kissell in the May 4 primary.

"Why would he jump the Democratic ship and vote against his party's signature, number one issue when there's a very compelling case for health-care reform in this district?" asked Nancy Shakir, head of the Cumberland County Progressives. Shakir and other Democrats staged a rally last month outside Kissell's Fayetteville office, where people waved signs reading "Blowing the Whistle on Kissell" and "Give Kissell a Big Dismissal."

"I expected him to go up and fight with other Democrats to bring true reform," said Ruth Derrow, 64, a Concord Democrat who voted for Kissell. "If he's only in there one term, then make it a good one term."

Kissell is struggling to find that political sweet spot that meets his base's expectations while bowing to his district's realities.

Taking a risk

In a district Obama carried by five percentage points, about one in four residents is black, and there are pockets of liberal Democrats in the Charlotte area. But many rural white voters here are deeply skeptical of big government programs, according to political analysts, and the electorate in off-year elections tends to skew heavily toward seniors -- the age group that most strongly opposes health-care reform.

"It's sort of like which devil do you fear the most?" asked Gary Pearce, a longtime Democratic operative in North Carolina. "Are you more afraid of the party base or are you more afraid of the health-care reform opponents?"

Kissell picked the latter, and it may have been the wrong bet. Conservatives who oppose the reform effort are unlikely to vote for a Democrat regardless of how he votes, Pearce said, yet Kissell cannot win reelection without the support of his base.

"That's why they call them freshmen -- because they make freshman mistakes," he said. "That's why a lot of them don't become sophomores."

www.washingtonpost.com/wp-dyn/content/article/2009/12/17/AR2009121704799.html