Sen. John McCain (R-AZ) returned to Washington mid-recovery from brain surgery with an impassioned speech about bipartisanship and a striking declaration that he would not support the Senate’s health care bill.

“I will not vote for this bill as it is today,” McCain said on the Senate floor, after voting to proceed “to allow debate to continue and amendments to be offered.” He castigated the bill’s secretive process and called for the Senate to “return to regular order” in the Senate.

Six hours later, McCain voted for the Senate’s health care bill.

Technically, he voted on a senate procedural matter — on whether or not the bill satisfied budget rules. And on Tuesday, McCain’s aide pressed that he did not vote for the bill, but rather in favor of opening the amendment process.

Update: McCain spokeswoman says his vote for BCRA last night "was procedural" & he remains opposed to current bill pic.twitter.com/gu8D59Jlud — Russell Berman (@russellberman) July 26, 2017

But it was not lost on any senator on the floor Tuesday night that their vote was a yea or nay on the Better Care Reconciliation Act itself.

The legislation, which Republicans labored over for months using a secretive and confusing process, would have resulted in 22 million fewer Americans having health insurance. McCain was among the loudest voices against Senate leadership’s closed process on health care. He told Vox he would have run the show “dramatically different.”

“We would be having debate on the floor we would be having amendments, we would be having discussion,” McCain said in June.

Senate Majority Leader Mitch McConnell went through many hoops to try to save it, but ultimately, on Tuesday night, it failed.

Senate procedure requires Republicans to start their floor debate with the American Health Care Act, the bill the House passed in May. McConnell can substitute another bill for a final vote. Senators can also offer unlimited amendments during the process. McConnell first offered the BCRA as the substitute.

But the bill was destined to fail on the floor. Because of Senate rules, the latest version of the bill — which included a provision from Sen. Ted Cruz to allow for plans noncompliant with Obamacare regulations, and another amendment from Sen. Rob Portman to add money to Medicaid — needed 60 votes to pass, and it was certainly not going to get eight Democrats on board, let alone 52 Republicans.

Even with McCain’s vote, nine Republicans, free of party pressure, voted against the BCRA Tuesday night.