Not that it’s the most important fallout, but this vote is very bad for McCain. He was trying to get House Republicans on board, after all, and he failed. Blaming the Democrats for the failure will not and should not work, given the ratios on both sides.
But several conservatives voted for the bill, including Blunt, Boehner, Camp, Cantor, Kline, Lungren, McCrery, Putnam, (Paul) Ryan, Tancredo, Weldon, (Joe) Wilson. I think they made the right call.