Health insurers on Tuesday offered up a list of actions they’d like to see Congress take once the ObamaCare repeal effort begins next year.

America’s Health Insurance Plans (AHIP), the leading lobby group for the insurance industry, acknowledged that “significant changes” are coming to the Affordable Care Act.

“Those changes can either begin a stable transition to a better approach, or they can bring about even more uncertainty and instability,” AHIP wrote in a summary of arguments it has been making on Capitol Hill.

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One of the biggest worries for insurers is that Republicans will quickly pass a repeal of the law, but then delay it going into effect for a few years to come up with a replacement. If Republicans pursue that strategy, insurers could flee the ObamaCare marketplaces, jeopardizing coverage for millions of people.

Insurers, therefore, are trying to get Republicans to take steps that would signal stability in the marketplaces in the period before any replacement for ObamaCare arrives.

Republicans are in talks with insurers about how to do that.

One of the ideas in the mix, which AHIP is calling for, is to extend an ObamaCare program called reinsurance, set to expire this year, until 2019. That program helps cushion insurers against financial losses by collecting funds from insurers and then making payments to insurers with particularly sick and costly enrollees.

Extending that program could be politically tough for Republicans, though, given that they have previously labeled it a “bailout” of insurers. The step could require taxpayer dollars.

Sen. Lamar Alexander Andrew (Lamar) Lamar AlexanderGraham: GOP has votes to confirm Trump's Supreme Court nominee before the election The Hill's Morning Report - Sponsored by Facebook - Washington on edge amid SCOTUS vacancy This week: Supreme Court fight over Ginsburg's seat upends Congress's agenda MORE (R-Tenn.), the chairman of the Senate health committee, on Tuesday left the door open to some sort of measure to aid insurers and increase stability.

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“I think we'll have to have a transition period for that part of the market that makes it likely that insurance companies will be willing to sell into the individual market so Americans will have insurance they can buy,” Alexander said. “And we'll probably have to do some things during that transition of a couple of years that we wouldn't do on a permanent basis.”

Asked if that would involve spending federal money, Alexander said, “Well let’s just see, let’s just see.”

Insurers are urging Republicans not to cancel ObamaCare payments called cost-sharing reductions, which reimburse insurers for giving discounts to low-income ObamaCare enrollees on their deductibles.

Those payments are the subject of a House Republican lawsuit against the Obama administration, with lawmakers arguing the payments are being made illegally.

The incoming Trump administration will have to decide whether it wants to maintain the payments for an interim period to keep insurers from bailing out of the market.

Notably, insurers are not calling for ObamaCare’s individual mandate — the requirement that everyone have health insurance or pay a fine — to remain in place.

That would probably be a losing battle, anyway, given that the mandate is one of the most unpopular parts of the law. Insurers favor it because it makes sure healthy people enter the market, keeping premium costs down.

AHIP instead says some policy with a similar goal, making sure healthy people sign up, should be part of a replacement. It offered up, for example, the idea of charging people more for insurance if they are signing up late.

ObamaCare’s expansion of expansion Medicaid, the health insurance program for low-income people, is also an issue, given that Medicaid is often administered by private insurers. AHIP said the Medicaid expansion has extended coverage to roughly 12 million people.

On Medicaid, AHIP calls for a “smooth transition that enables states to continue coverage if they choose.”

AHIP is taking a less negative take on repeal than other parts of the healthcare industry.

Hospitals on Tuesday took a more aggressive tack, warning against the effects of repealing ObamaCare without a replacement.

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The American Hospital Association released a report saying that repeal of ObamaCare without a replacement could mean hundreds of billions of dollars of losses for hospitals.

“Losses of this magnitude cannot be sustained and will adversely impact patients’ access to care,” the AHA said.

The AHA wants restoration of hospital funding cuts under Medicare to be a part of any repeal bill.

In addition to the funding issues, though, the hospital group said repeal of ObamaCare would cause 22 million people to lose coverage by 2026.

"This reversal of coverage would represent an unprecedented public health crisis," the hospitals said.