I don't doubt for a second that Perriello votes with his conscience. Unfortunately (for him) his district is far more Conservative than he is, thus making himself far more vulnerable than Blue Dogs like Bobby Bright, Ike Skelton and Walter Minnick.
What's so unfortunate for him? He cares more about getting stuff done than having a long career in office, and he was able to do that.
Skelton, Bright, and Minnick would be plenty vulnerable if Skelton hadn't been in office for 30 years and if Bright and Minnick's districts weren't so conservative that the Republican primary turned into a circular firing squad, leaving only the least electable standing. As it was, if Hurt lost to a Teabagger, Perriello would be stronger. Also, as I said in a post a second ago, this district voted for Obama while none of the others came close to doing so.
The biggest factor in Perriello's loss won't be that he supported bringing health care to the 20% or so of people in his district without it, but because the economy is still in the toilet, and with it, the Democrats' macro potential. Also--and this too is beyond Perriello's control--that the electorate in this district varies widely between Presidential election years and off-years. Why shouldn't he represent the electorate that chose him? Did he pretend he was going to be a thorn in Obama's side when he campaigned in '08? I think he's always been a straight shooter.
