Though the votes haven’t been cast yet, today’s decision by Sen. John McCain (R.-Ariz.) to vote no appears to be the end of the Senate’s latest effort to repeal and replace Obamacare.

Sen. Rand Paul (R.-Ky.) is also on the nay record, leaving Sens. Susan Collins (R.-R.I.) and Lisa Murkowski (R.-Alaska), who lean toward the no vote, to bring 50 needed votes to the table to pass the Graham-Cassidy bill, which would replace Obamacare exchanges and subsidies with block grants to the 50 states. (Senate President Mike Pence would provide the 51st and deciding vote.)

“I would consider supporting legislation similar to that offered by my friends Senators Graham and Cassidy were it the product of extensive hearings, debate and amendment. But that has not been the case,” McCain said. The Senate Finance Committee has scheduled a hearing on the bill for Sept. 25, though it probably won’t be enough to satisfy McCain.

The Republicans have until Sept. 30 to use the reconciliation process to change the Affordable Care Act (ACA) with just 51 votes. After that date, any such bill would be subject to filibuster and thus need 60 votes to pass.