One thing one can always count on Sen John McCain, R-Arizona is that one cannot count on him. McCain has announced that he cannot “in good conscience” support the Graham Cassidy Obamacare Repeal and Replace bill. McCain has very likely killed the bill, barring a miracle. Great rejoicing could be heard from left, including from Jimmy Kimmel, late night talk show host turned health care warrior. The rest of America who thought it had elected a Republican government to rid itself of Obamacare is learning once again to live with disappointment.

What were McCain’s objections?

According to his statement, McCain seemed to have decided to vote against Graham Cassidy because of process reasons. The bill will not have been fully scored by the Congressional Budget Office. It will not have gone through “regular order” of hearings, debate, and amendments. The bill will not be bi-partisan, a particular fetish of the senator’s.

One can be forgiven for wondering if something lurks in McCain’s psyche that causes him to buck his own party when it needs him the most. This trait made him beloved by the media, but well loathed by many movement conservatives. He managed to set his maverick tendencies aside during the 2008 presidential campaign to run as a Reagan Republican.

Now, doing battle with cancer and likely toward the end of his life, McCain had extended a middle finger toward his party, his constituents, and the American people. What many would call an act of treachery is a curious legacy for a man whose wartime heroism has been rightly celebrated.

What happens next?

Unless Senate Majority Leader Mitch McConnell works a miracle, repeal and replace is dead for the year, likely for the rest of the current term.

Obamacare will continue to descend into its death spiral, Americans will continue to be socked with exploding premiums, deductibles and co-pays. Health insurance for people on the exchanges will continue to be substandard.

One silver lining, contrary to the hopes of some and the fears of others, is that the likely collapse of Obamacare repeal and replace does not increase the likelihood of single payer.

Math argues against the seizure of health care by the government. “Medicare for All” will be too expensive, too dysfunctional, and too tyrannical for Americans to tolerate. No Congress would dare pass it without incurring the wrath of the American people.

McCain will continue his cancer treatment and will continue to serve as a senator as long as he is physically capable. It is hoped that he lives a long life, regardless of his chances, not only for the sake of his family but so that he might live long enough to understand the extent of his folly.