John McCain often gets cast as a truth-teller to Donald Trump, but his voting record says otherwise. And nowhere was that more clear than on Tuesday when, despite his own ill health, when it came to the decision of whether to take other people’s healthcare away, he cast a decisive vote in the wrong direction.

Addressing his fellow lawmakers, McCain called passionately for a return to regular order, and for senators to work constructively across the aisle. “Why don’t we try the old way of legislating in the Senate, the way our rules and customs encourage us to act,” he said in his Tuesday speech. “If this process ends in failure, which seems likely, then let’s return to regular order!”

Though he has often railed against Trump as if he can’t actually affect what he is complaining about, McCain isn’t a helpless observer – he’s an influential senator. And on Tuesday, as the country draws closer than ever before to the death of the Affordable Care Act, he was a pivotal one.

Had McCain simply voted no to the question of whether the Senate should begin debate on a repeal or replacement of Obamacare, which squeaked by in the Senate with a vote of 51-50, the chamber’s leader Mitch McConnell might well have been forced to do the very thing McCain claimed to want: restore the chamber to order.

Instead, McCain, who was recently and tragically diagnosed with an aggressive form of brain cancer, and who returned to DC explicitly to help save the GOP healthcare bill, voted yes.

To put it another way, faced with a rare opportunity to make a real tangible difference, he risked traveling amid failing health to make possible the very thing he decried.

More damningly, he voted yes to take away healthcare from millions of Americans – including an untold number of other cancer patients – even as he continues to access benefits of the quality care afforded him as a senator, care subsidized by American taxpayers.

Never mind that at this point in time Republicans have little idea what the bill they would replace Obamacare with will contain. Never mind that we have arrived at this point through a secretive process devoid of public hearings, or even that Republicans would have the healthcare of millions of American women dreamed up entirely by men.

Politics appears to have triumphed over logic. Sadly, the politics that won out today are not even a sort personally dear to John McCain – that much was made clear in his floor speech. It’s not even his own electoral politics that won out, either; after a tough re-election battle, he won’t be up again until 2022, freeing him up as much as electorally possible to act solely with his moral compass as the guide.

Instead, McCain did the very thing he had just railed against, acting out of partisan loyalty.

There are many reasons to respect McCain, a former prisoner of war who endured torture in the five and a half years he spent captive in North Vietnam, and has campaigned against torture by the US. His 2008 campaign against Barack Obama now looks like the very model of civility in the wake of Trump.

But even his remarkable stoicism and service can’t excuse what he just did.

The grim reality is that health insurance is of the utmost importance when it comes to surviving cancer, the second leading killer in America after heart disease. Put simply, the uninsured are much more likely to die than those with insurance – and sooner.

A recent study in the journal Cancer found the uninsured were 88% more likely to die of testicular cancer than those with insurance. For patients with Medicaid, the number dropped to a 58% greater chance of dying than privately insured patients like McCain.

The study found the same trend held true for patients with glioblastoma, the malignant brain cancer McCain was recently diagnosed with. It’s a terrible disease with a median life expectancy with his type of just 15 months, and that’s as true for McCain as anyone, but the uninsured still die faster than anyone.

Voting to subject any one of millions of Americans to go to meet such a fate without even the benefit of the best tools medicine has to fight it is cruel, given McCain’s new-found appreciation of the benefit.

The estimated cost of McCain’s recent surgery to remove the cancer above his eye is a sum that would bankrupt many Americans, using the Medicare rates for which McCain qualifies.

There’s a way to fix the fact that many Americans under the age of 65 don’t have access to any such care: let everyone under it buy in, a scheme for which many on the left have argued. But on Tuesday, McCain helped move the country in precisely the opposite direction.

We still don’t know which of several bills Republicans will bring up for a vote, but all of them involve millions of Americans losing the very sort of health insurance upon which McCain depends.

The only question is whether it’s a matter of 22, 32 or “just” 15 million people who will lose access. What we can say with confidence is whatever version moves forward, McCain’s lost more than his good health – he’s lost his decency.