It makes Paul wrong if his vote is the one that kills repeal. Not that he cares. He and his family are exempt from Obamacare, so he has no skin in the game.
I am certain that the true powers arrayed against us would like nothing better than that outcome, and are likely “negotiating” to that end if they, in fact, intend for this not to pass.
Marginalizing the Pauls whenever they point at government overstepping its bounds, is required and automatic. They need someone to be a reminder to others of how marginalized you can get if you do that.
That way, they can say to the rest of us “Rand Paul thinks that! You can’t possibly agree with anything he thinks, can you?”