http://www.dailykos.com/storyonly/2009/11/9/802293/-The-Dems-Who-Cast-the-Toughest-VotesThe above post describes the Dem US House members who were in the toughest positions in their district for re-election, but who stood up and cast the key yes votes for health insurance reform over the weekend. The two from PA were Carney from NE PA and Dahlkemper from NW Pa.
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The interesting thing is that people from rural districts (like these two) often need health insurance reform more than anyone. Rural districts typically have lower rates of employer provided health care than suburban areas and they typically have less competition among insurance providers.
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Now the Repubs are attacking Dem congressional challengers if they don't come out for or against the House bill. They are trying to get the challengers on the record as supporting a particular bill so some particular provision of it can be used against them in ads.