“We must now return to the correct way of legislating and send the bill back to committee, hold hearings, receive input from both sides of aisle, heed the recommendations of nation’s governors, and produce a bill that finally delivers affordable health care for the American people,” McCain said in a statement after the vote. “We must do the hard work our citizens expect of us and deserve.”

It was a remarkable turnaround from Tuesday. Mr. McCain, diagnosed with brain cancer just days earlier, arrived in the Senate after only a brief medical absence to provide the vote Republicans needed to open debate on their jumbled efforts to find a legislative path to topple the health care bill they have railed against for seven years. Mr. Trump, who once mocked Mr. McCain’s ordeal as a prisoner of war in Vietnam, praised him.

Leading up to the vote, Mr. McCain, not untypically, had confounded both critics and admirers. His speech Tuesday had the potential to go down as a Senate classic, a call to restore the work-across-the-aisle traditions of the past.

“We’ve been spinning our wheels on too many important issues,” Mr. McCain scolded his colleagues. “We’re getting nothing done, my friends, we’re getting nothing done.”

Mr. McCain’s vote that day left Senator Mitch McConnell, the majority leader, smiling as his sometime-foe, sometime-friend from Arizona helped rescue the Kentucky Republican’s reputation as a master strategist.

He provided the vote to move the Republican measure forward and seemed to work throughout the week with his constant ally Senator Lindsey Graham, Republican of South Carolina, to explore ways to get the legislation out of the Senate and over to the House as Mr. McConnell wanted.

A hastily scheduled Thursday evening news conference set off alarm bells among Democrats that Mr. McCain was going to back the “skinny” last-ditch repeal effort and sustain the drive to overturn the Affordable Care Act.

But he had also been working back channels with Senator Chuck Schumer of New York, the Democratic leader, about his intentions. A relieved Mr. Schumer praised Mr. McCain after the vote.

“John McCain is a hero and has courage and does the right thing,” Mr. Schumer told reporters after the vote. “He is a hero of mine.”

Mr. McConnell wasn’t smiling any more.

“So yes, this is a disappointment,” the majority leader said in an emotional speech after the vote. “A disappointment indeed.”

The question now is whether Mr. McCain’s bold move will produce the results he wants: a more bipartisan approach to making changes in the health law that both sides acknowledge are needed. Or will it simply produce a stalemate that leads to a failure of the current system and a chorus of “we told you so” from Republicans?

The president made clear his unhappiness and issued a warning of what would come.

But for the moment, it was Mr. McCain who had single-handedly seized the moment and set the course of the Senate.

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