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At an event in Wisconsin on Wednesday, Speaker Paul Ryan said Republicans would revisit health care reform and changes to programs like Medicare if they retain control of the House and Senate following November’s elections.

The comments came after Ryan claimed health care reform is needed to avoid “bankrupting the country” during an event hosted by the website WisPolitics. His interviewer noted reforms would require cooperation in the Senate, which declined to pass the GOP’s Obamacare repeal bill last summer.

“I think the election will have to determine that based upon what our vote count looks like in the Senate,” he said. “If we keep the House majority, which I think we will. And then you have to make sure you have a big enough of a majority in the Senate to be able to pass health care reform.”

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Ryan, who is not seeking reelection, pointed out that last year’s effort to repeal Obamacare failed in the Senate by a single vote. He was referring to Sen. John McCain’s tie-breaking thumbs-down vote last July killing a bill that would have permanently repealed the individual mandate and other key provisions of the Affordable Care Act. McCain said his dramatic, middle-of-the-night vote breaking was made in disapproval of the rushed, closed-door process that Republicans had used to bring the repeal effort to the floor. It has become known as one of McCain’s last legislative coups before his death from cancer last month.