Let me start off by saying that if I were in Rep. Kucinich's shoes, I would vote yes on the Senate version of HCR. Not only would this allow desperately needed HCR to move forward (maintaining the hope of improvement in the future), but I would calculate that it would provide me with a pantload, if not pantloads, of leverage with the White House and the Dem caucus for the future. But I am not Dennis Kucinich.
And no one really knows exactly what Mr. Kucinich will ever do, except Mr. Kucinich. Based upon my experiences in work on economic development projects with him many, many years ago and his conduct of the past 6 years or so (heck, his whole political career), I imagine he will stick to his guns, regardless of reason, and vote no. Should he be criticized? Yes, definitely. Should he be demonized as it appears he will be if he takes that route? No, definitely not.
First, Kucinich is probably one of the brightest and well-prepared men in Congress. A flake, yes. Oddball, yes. But there is no doubt he has studied HCR and has a grasp of the issues that far exceeds that of his fellow Congressfolk. He knows what is ultimately best for this country and he understands that to truly help 'the people', and not provide huge giveaways to the businesses who have been ripping 'the people' off for all these years, single-payer or medicare for all is the only way to go. So, in his misguided efforts, at least he is fighting for true improvement of the system, improvement that would provide huge benefits to 'the people'.
Second, related to the above, his heart is in the right place. Unlike Stupak and Stupak's deadly dozen, Kucinich isn't seeking to limit any other person's or group's rights, at the cost of something as important as HCR, in order to push an ideology that isn't supported by the majority of this country. Scorn, derision, and demonization should be reserved for folks like Stupak and his cowardly followers. At least with Kucinich, the stand he is likely to take is in support of providing better (and simpler?) HCR to the American public, without discrimination of any kind and without stomping on the lawful rights of others.
Third, sort of related to 'second' above, to some extent I really understand each and every single-payer advocate's opposition to or hesitation with the Senate version of HCR. Folks like these, including Kucinich, never had a seat at the table when it came to HCR. Obama and the top Dems in Congress removed that option from the process immediately. Hell, can it even be said that it was part of the process? They were forced to watch, unable to challenge, as HCR was continuously watered down further and further and further, to a program that would basically throw their constituents into the fires of Big Health Insurance. Yet folks like Stupak, and Landrieu, and Nelson not only received a fair viewing of their ideas (and I use that word loosely), but they were wined and dined and kowtowed to for the entire process. To this day. I find this to be insulting, and I can imagine that folks who were elected to represent people like me, like us, felt even more insulted and marginalized, and by the very politicians who now need their vote. As I said earlier, if it were me I would vote yes and extract leverage. But I understand why someone like Kucinich might not chose that path.
Finally, as to calls for a primary of people like Kucinich, there should always be primaries for our elected officials. Keep them on their toes and honest. But to think a primary will have any effect on someone like Kucinich is misguided at best. Other than his really stupid runs for POTUS, Kucinich has done a fairly good job of actually representing the views and needs of his constituents over the years. And one of the things his constituents have grown to like about him, expect in him, is that he generally does have his constituents' best interests in mind when he takes a position, and they know that he will fight for that position, for them, when the time comes. If only some other leading national Dems had this sort of fight in them, the Dem party might not be looking as haggard as they are right now. I have no doubt Kucinich will be able to turn a no vote on the Senate version of HCR to his advantage come election time--he will show how he had a backbone and tried to lead when others folded to insurance special interests, as well as the anti-choice lobby; he will show how the Senate version was a big payday to insurance special interests and how it forces those who can't really afford most health insurance right into the arms of those who have been screwing them all these years; and he probably has an idea that most in his district actually prefer single-payer/medicare for all, so he will be able to argue that he was simply supporting his constituency (if it is OK for Ben Nelson to do this, as has been argued time and again, or Bart Stupak, or Mary Landrieu, why nor Dennis Kucinich).
The defense, albeit somewhat weak, rests.