Hours after infirm, irony-resistant Senator John McCain cast a decisive vote in favor of debating destroying health care access for sick and injured people on Tuesday, that discussion kicked off with a firm rejection of Republican policy.

On Tuesday night, Republican senators failed to garner the 60 votes they needed to overcome the parliamentary objection placed upon the first version of the Better Care Reconciliation Act. In fact, nine Republicans helped Democrats reject the measure, resulting in a 43-57 vote against. McCain voted for the BCRA, despite pledging a few hours earlier that he would not. The twist is that everything would up exactly as you thought it would.

The vote was technically focused on a procedural question of whether one of the bill’s provisions, the Consumer Freedom Option, drafted by Ted Cruz, complies with Senate rules. Cruz’s amendment would allow insurers to sell cheaper and worse health care plans so long as they also offer at least one plan that complies with the Affordable Care Act. Even Republican Senator John Cornyn of Texas said the provision could do with some editing. “Otherwise,” said the senator, “what you do is have adverse selection. Younger healthy people pick the cheaper policy, leaving older, sicker people on the other policy, which would have to be subsidized dramatically in order to make it affordable.”

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Cruz said, optimistically, from the Senate floor Tuesday night,“I will say the bill before the Senate ... is not likely to pass tonight but I believe at the end of the process the contours within it are likely to be what we enact, at least the general outlines.” Cruz believes his provision will be included in the final version of the BCRA.

This latest setback for Republicans doesn’t mean the entire bill is dead, but it will need to be substantially reworked to have a chance in the Senate. Now that McCain has inadvertently called his party’s bluff, there really is no clear way forward for the Republicans. Another repeal Obamacare vote is expected to take place on Wednesday.