Gulp. That’s what every liberal on Twitter did Monday morning at 11:50 a.m. when Benjy Sarlin, who covers the Hill for NBC, tweeted:

And then, another gulp about two hours later, when the very man McCain cited in his tweet, Arizona Governor Doug Ducey, issued one of his own:

If you’ve been following the latest goings on in the Senate on health care, you know just how ominous this is. The last time Senate Republicans tried to undo Obamacare, with the “skinny” repeal bill, it was John McCain’s dramatic post-midnight thumbs down that killed the effort. Without him, that awful bill, which would have thrown millions off the health-insurance rolls and dramatically slashed Medicaid, might well have passed.

And now, this new Graham-Cassidy bill, which would throw millions off the health-insurance rolls and dramatically slash Medicaid, might pass McCainian muster? How does that stand to reason?

It doesn’t.

A little background. Think back to McCain’s floor speech the night he cast his mavericky no vote. Remember what it was all about? Regular order. He said: “I hope we can again rely on humility, on our need to cooperate, on our dependence on each other to learn how to trust each other again and by so doing better serve the people who elected us. Stop listening to the bombastic loudmouths on the radio and television and the Internet. To hell with them. They don't want anything done for the public good. Our incapacity is their livelihood. Let's trust each other. Let's return to regular order.”

What does regular order mean? Just the normal way of doing business; what we were all taught in school about the way Congress works. Legislation is introduced, there are hearings, there’s an attempt at consensus.

Graham and Cassidy—and yep, Graham is Lindsey Graham, McCain’s BFF—dropped their bill on September 6. That same day, McCain issued the following statement, italics mine: “I am committed to working with Governor Doug Ducey to ensure the final outcome of health care reform benefits the people of Arizona. While I support the concept of the Graham-Cassidy proposal, I want to see the final legislation and understand its impact on the state of Arizona before taking a position. As I have said all along, any effort to replace Obamacare must be done through the regular order of committee hearings, open debate and amendments from both sides of the aisle.”

Must. Not “preferably will.” Not “should.” Must!

And yet, that very same September 6, when Hill reporters asked him if he was supporting Graham-Cassidy, he said: “Yes. You think I wouldn’t be?” It would seem there that his meaning was that yes, of course I’m for it, it’s my best buddy’s bill.

What are we to believe—a statement written by a staffer or what he told reporters? I don’t think we want to know. But still, the statement counts. He most likely at least read and approved it before it went out.

And he got a mountain of love for casting that vote and for making his plea for regular order; for doing things the way they did them in the old days. The maverick is back! People gushed about him for days. I did a little of this myself, although reading back over that column today, I’m relieved to see that I mostly contained myself. I did write that that moment “will be remembered as the day John McCain decided to be a senator again.”

That was true. Mr. Maverick had been in hibernation for a decade or more before that vote, but at least he returned. And now, has he decided to go back the other way? It looked then, in late July, right after his cancer diagnosis, as if he wanted to go out on a respectable note. That’s why everyone fell so hard for that regular-order stuff. But if he votes for this, he’s back to being an apparatchik, nothing more.

Maybe, you’re thinking, there are differences between that bill and this one—in other words, substantive reasons to back this bill? Oh, there are some differences. The main one is that Graham-Cassidy (Cassidy, by the way, is Louisiana Republican Bill Cassidy) delays the harshest Medicaid cuts until after 2026. Gee, why would that be? It couldn’t have anything to do with the fact that the Congressional Budget Office only scores these bills 10 years out, and therefore the harshest, meanest cuts—cuts that will mightily jack up the projected number of uninsured, for example—only come after the CBO scoring window, could it?

McCain doesn’t need the CBO to know what this bill portends for his state of Arizona, and neither does Governor Ducey. The Center on Budget and Policy Priorities (CBPP) ran the numbers on Graham-Cassidy and found that Arizona will lose $1.6 billion in Medicaid funding through 2026. That will make the Grand Canyon State one of the bigger losers in this deal. Fourteenth biggest, by my count. That’s something the governor and senior senator want to be party to?

After being caught a bit unawares by all this last week, it now looks as though the progressive side has woken up and is trying to rally the troops. A vote has to happen under the rules by September 30. It’s going to take another enormous effort,like the one from the summer that led to McCain and Lisa Murkowski and Susan Collins voting no, to take down Graham’s bill.

One assumes, for now, that Murkowski and Collins will stay in the no column. Alaska and Maine both lose substantial funding in this bill, too. Rand Paul says he’s a no, but he said that last time; the suspicion is that he’s saying no for tactical reasons and will have a chat with Mitch McConnell, get some assurance, and shift to yes. Jerry Moran of Kansas is a possible wild card. But Kansas will gain $821 billion under this bill, according to the CBPP numbers. Shelley Moore Capito and Bob Portman might vote no, maybe, conceivably; West Virginia and Ohio will be hit hard by this bill. But they’ve always been reliable party robots.

Maybe some other combination of people will block this. But it looks like McCain is lost. If he is, every word he said back in July about regular order and committee hearings and respecting each other will be rendered a sick joke. The joke’s on the Beltway insiders who are always too quick to praise him, but to the millions who’ll lose health coverage it’s not a joke at all.