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He didn't vote against the repeal of Obamacare because he believed poor and middle-class people should have health care but because of a subversion of the legislative process (and probably to thumb his nose at Trump). He voted against the Affordable Health Care Act the first time around and remained opposed to universal health care.
¡apesta!
One example is his voting against the repeal of Obamacare.
He knew he would be vilified by his party for it. He did it because he thought it was the right thing to do.
You can see videos of him casting his vote. Mitch McConnell is behind and looks like he wants to kill McCain, right there on the floor of the Senate.