Now this is the kind of Democratic primary challenge I can get behind:

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Democrats in safe seats like Kucinich would be insane to vote against this bill. Of course, Kucinich is insane, but that's all the more reason to replace him with a Democrat who isn't.

Meanwhile, even non-Kucinich Democrats need some pressure. They all clearly have a strong political interest in passing. The trick is to get House members, especially ones who voted against the first bill, to support it this time around. As Karen Tumulty notes, Democrats who voted against the original bill have a collective action problem -- they badly need the measure to pass, but they'd prefer for it to pass while they vote no. The logical response for the Democratic base to do is threaten to defeat members who fail to support reform if the bill dies. This kind of thing is exactly what needs to happen:

In a series of conversations with the Huffington Post, many of labor's leading voices pledged to launch a massive, arm-twisting effort to help persuade skeptical lawmakers to pass health care legislation into law. And in addition to their traditional ammunition -- from email campaigns to town hall events -- talk also centered on exacting electoral revenge against those who end up voting against reform.
"I hope this sends a message to Congress," Gerald McEntee, president of 1.6-million-member AFSCME, told the Huffington Post. "I think we have to demonstrate that we are not going to stand aside, that we are going to take them out if they don't help us at all."

Normally I oppose this sort of friendly fire. But this is an extreme circumstance, and the Democratic base needs to let its representatives know that the they will intentionally work to defeat members who try to save their own skin in a way that just gets everybody (including themselves) killed. It's kind of like the logic of executing deserters in wartime: Yes, the enemy might shoot you if you fight, but we will shoot you if you don't. That tends to clarify the muddled incentive structure. I'd prefer that the Democrats not let this become standard operating procedure, which it basically is in the GOP, but unusual circumstances call for unusual measures.