U.S. Sen. Rob Portman vowed Friday to continue fighting for a bill to repeal and replace the Affordable Care Act, or Obamacare, despite the narrow defeat early Friday of a Republican repeal effort.

At the end of the day – more accurately, the wee hours of Friday morning – Portman, R-Ohio, voted in favor of the scaled-down “skinny repeal” Senate health care package in order to advance the measure to a House-Senate conference designed to continue work on the bill.

But the support by Portman and a handful of other swing GOP senators who joined the rest of their Republican colleagues in voting for the bill still wasn’t enough after Sen. John McCain from Arizona voted against the measure, joining Senators Lisa Murkowski of Alaska and Susan Collins of Maine as the only Republicans opposing the bill, which was defeated 49-51. Some reports indicated that McCain took Republican leaders by surprise when he cast his nay vote.

Earlier, Portman joined 42 other GOP senators voting in favor of a procedural vote on a broader repeal-and-replace package.

But he was one of just seven Republicans to vote against a repeal-only amendment offered after the failure of the broader bill. Other Republicans voting against the repeal-only bill were Collins, Murkowski, McCain, Dean Heller of Nevada, Lamar Alexander of Tennessee and Shelley Moore Capito of West Virginia.

Portman voted in favor of an identical bill two years ago when President Obama was still in office. But unlike then, at least 19 Ohio counties have now found themselves without any health insurance providers. Portman has said he cannot support a repeal plan without a replacement in place, even though the repeal-only bill would not have gone into effect for two years under a plan that would have allowed Republicans time to come up with a replacement plan.

On Thursday, Portman announced he would vote in favor of the “skinny repeal,” saying, “I will support legislation to move this process to a House-Senate conference because I believe we need to repeal and replace Obamacare. This law isn’t working for Ohio families and small businesses who’ve seen their premiums and deductibles skyrocket. Throughout this debate, I have fought for Ohio priorities, including adding to the Senate replacement bill an unprecedented $45 billion in new resources for opioid treatment and $100 billion to help low-income Americans get high-quality, affordable health care.”

Friday afternoon, amid the fallout from the failed “skinny repeal” effort, Portman issued a statement promising to continue fighting for a repeal-and-replace bill.

“I know some may want to throw in the towel and do nothing, but I don’t believe that is the responsible course of action,” said Portman. “Doing nothing would leave tens of thousands of Ohioans stranded without health insurance and everyone with higher costs. We can do better, and I’m not giving up. I will continue working with my colleagues on both sides of the aisle on common-sense solutions on behalf of Ohio families who are suffering under the failed status quo. I hope the Senate Finance Committee, on which I serve, will announce a series of health care hearings.”

Portman’s Ohio counterpart in the Senate, Democrat Sherrod Brown, issued a statement Friday saying, “This bill failed because people in Ohio and all across the country spoke out and shared their stories. Let’s kick the drug company and insurance industry lobbyists out, listen to the people we serve and come together to lower prices and make healthcare work better for everyone.”

For now, the GOP’s failure to pass a repeal bill leaves Obamacare in place.

Senate Democrats voted solidly against every version of the bills this week. “It’s time to turn the page,” said Senate Minority Leader Charles Schumer of New York. “We are not celebrating. We are relieved.”

“This is clearly a disappointing moment,” said Senate Majority Leader Mitch McConnell, R-Ky. “I regret that our efforts were not enough, this time. It’s time to move on.”

McConnell put the health bill on hold and announced that the Senate would move onto other legislation next week.

President Trump responded on Twitter: “3 Republicans and 48 Democrats let the American people down. As I said from the beginning, let ObamaCare implode, then deal. Watch!”

Buoyed by a signal from House Speaker Paul Ryan, McConnell had introduced the pared-down health care bill late Thursday that he hoped would keep alive Republican ambitions to repeal Obamacare.

McConnell had called his measure the Health Care Freedom Act. It was not intended to become law, but to open a path for a House-Senate conference committee to try to work out comprehensive legislation Congress could pass and send to Trump.

The measure would have repealed the unpopular Affordable Care Act requirement that most people have health insurance or risk a fine from the IRS. A similar requirement on larger employers would be suspended for eight years.

Additionally it would have denied funding to Planned Parenthood for a year, and suspended for three years a tax on medical device manufacturers. States could seek waivers from consumer protections in the Obama-era law, and individuals could increase the amount they contribute to tax-sheltered health savings accounts for medical expenses.

Ryan, R-Wis., seemingly opened a path for McConnell earlier Thursday evening by signaling a willingness to negotiate a more comprehensive bill with the Senate. Some Republican senators had been concerned that the House would simply pass the “skinny bill” and send it to Trump. That would have sent a shock wave through health insurance markets, spiking premiums.

Ryan sent senators a statement saying that if “moving forward” requires talks with the Senate, the House would be “willing” to do so. But shortly afterward, his words received varied responses from three GOP senators who’d insisted on a clear commitment from Ryan.

“Not sufficient,” said McCain, who returned to the Capitol Tuesday. The 80-year-old McCain had been home in Arizona trying to decide on treatment options for brain cancer.

The insurance company lobby group, America’s Health Insurance Plans, wrote to Senate leaders Thursday saying that ending Obama’s requirement that people buy insurance without strengthening insurance markets would produce “higher premiums, fewer choices for consumers and fewer people covered next year.”

And a bipartisan group of governors including John Kasich of Ohio and Brian Sandoval of Nevada also announced against it.