House Budget Committee Chairman Paul Ryan tells THE WEEKLY STANDARD that Republicans will be able to "effectively repeal" Obamacare with a simple-majority vote in the Senate if they control Congress and the White House in 2013. By using the budget reconciliation process, repeal of Obamacare would not have to get the standard 60 votes needed to break a filibuster in the Senate.

"I feel very confident we can effectively repeal the law through reconciliation. Whether we can get every line and subsection of the bill will be a question up to the Senate parliamentarian at the end of the day," Ryan says. "But the guts of this bill are all fiscal matters, which are clearly included in reconciliation."

"There's one more chance, just one more chance, to get at this law," says Ryan. "And it's this election." If Republicans hold the House of Representatives and take the Senate and White House in November, Ryan says Republicans clearly will be able to repeal "all of the spending, the subsidies, the taxes, the mandates" in Obamacare. "That effectively repeals the law."

But it's not clear if the Senate parliamentarian, who is appointed by the Senate majority leader, would allow some of Obamacare's insurance regulations to be repealed through reconciliation.

"I think you can make a very good case that some of the regulatory provisions in the law have huge fiscal effects and therefore ought to be part of reconciliation," says Ryan. "That's going to be a debate we'll have." For example, in the past, Senate parliamentarians have thwarted attempts to use reconciliation to pass medical liability reform and drilling for oil in ANWR.

Some of the Obamacare regulations, such as the "community rating" requirement for private insurers to sell plans at the same price to people regardless of their lifestyles or pre-existing health problems, might not make it through reconciliation. But without the mandate or "tax" requiring Americans to buy insurance, the Obamcare regulations would become even more dysfunctional than they're already going to be, as people would have greater incentive to wait until they get sick to buy insurance.

"We'll have a better answer for pre-existing conditions than what the law has," Ryan says of GOP plans to replace Obamacare. "The actuaries tell us that between 4 and 8 percent of the under-65 popoulation fall into that pre-existing condition category. And our argument has long been that if you target resources through various pooling mechanisms toward those individuals you can make sure that no one goes to the poorhouse."

Whether Republicans will have even 50 votes to repeal Obamacare in the Senate next year is uncertain. Right now, Republicans have 47 seats in the upper chamber and are likely to lose one with the retirement of Maine senator Olympia Snowe. The GOP will play defense in Massachusetts, but there are good opportunities for Republican pick-ups in Nebraska, Montana, North Dakota, Missouri, Wisconsin, Florida, and Virginia. Whether Republicans can make a net gain of three Senate seats, hold the House, and take the White House will determine the fate of Obamacare.

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