The Senate health care bill has gone down in flames, and Trumpcare appears to be dead.

The vote on the “skinny repeal” amendment, held around 1:30 early Friday morning, was 51 to 49 against. The three Republicans who voted against it were Maine Sen. Susan Collins, Alaska Sen. Lisa Murkowski, and, yes, Arizona Sen. John McCain, who ultimately lived up to his word about abandoning a secretive, partisan, rushed process and returning to regular order to consider fixing Obamacare’s flaws.

McCain kept how he would vote a mystery until he reached the floor, telling reporters to “watch the show” as he entered the Senate chamber. When he got there, he spoke to Democratic leader Chuck Schumer, who came away smiling. The reaction among Republican leaders with whom he spoke was notably frostier.

South Dakota Republican Sen. John Thune told me after the vote that leaders knew McCain had been “wrestling with it all day,” but nobody really knew how final his position was until he reached the floor and started having conversations.

“Some of the people who were close to him indicated that people needed to have some conversations with him,” Thune said. “But I think his mind was made up, and I’m not sure there would have been much that could have been said to change it.”

Indeed, if there was anything to change McCain’s mind, leaders tried it. The vote on the “skinny repeal” amendment came second after a vote on a Democratic motion to send the process back to committee. That first vote, though, was kept open for about half an hour after all 100 senators had voted, as Republican leaders were trying to gather the 50 votes they needed for the next one. Vice President Mike Pence, there to preside over the chamber in the event of a tie, tried to persuade McCain for about 15 minutes. It did not work. Nor did desperate efforts to persuade Murkowski. Pence eventually left the chamber.



The vote was held, it failed, and McConnell, clearly irritated, declared that it was time to move on.

Still, for now we can’t be sure how dead Trumpcare truly is. After the vote, McConnell put the bill on hold, even as his language carried the whiff of total defeat. And McCain seems to think it’s back to the drawing board, according to his statement:

Here is McCain's FULL STATEMENT on his NO vote: pic.twitter.com/ADRblPPzaf — Frank Thorp V (@frankthorp) July 28, 2017

The reaction from his fellow senators, though, seemed to indicate that this really was it.

Mississippi Sen. Roger Wicker didn’t have much more to offer when I asked him what came next with health care. Is this the end of the seven-year repeal drive? Is it time to work with Democrats?

“I really don’t know,” he said.

“That’s a good question,” Florida Sen. Marco Rubio said, when another reporter asked him what came next.

Sen. Mike Rounds said senators needed to move, quickly, on stabilizing markets ahead of 2018. “Go back to the drawing board again,” he said. “The question is do we have enough time to slow down the price increases that we know are coming. … How many carriers are you going to lose? That’s the question.”

The most candid reaction I got, though, was from Iowa Sen. Chuck Grassley, who was in no mood for future forecasting or the big-picture takeaways for which I was asking.

“Why don’t you go home and go to bed,” he said. “We all need to.”

This post has been updated.