A newly elected Republican state insurance commissioner is asking Republican congressional leaders to move to stabilize the commercial health insurance system that exists now while working on efforts to move to a new system.

The commissioner, Jon Godfread of North Dakota, may be contributing to the pressure on Republicans in Congress to work with Democrats to change or replace the current Affordable Care Act system.

Godfread, a former North Dakota business group executive who took a moderate approach to talking about the ACA while campaigning for the commissioner job, writes in his letter that the ACA has hurt his state's health insurance market.

In the long run, Godfread writes, Congress should give more power back to the states.

States should be able to design their own benefits standards and set their own product and rate review schedules, Godfread says.

But, while work is in progress, policymakers should keep the ACA public exchange system going, improve the exchange applicant screening process, and fully fund the three big ACA programs that were supposed to help health insurers cope with ACA-created problems, Godfread says.

"Businesses thrive on certainty and predictability," Godfread says.

Giving insurers some certainty, and giving them adequate time to adjust to any new rules and programs, will improve the results, Godfread predicts.

Otherwise, he says, "there is a potential for our markets to be undermined before any reforms can be implemented."

For Republicans in Washington, improving how the ACA system works in the short run may be especially tricky, because Republicans hold just 52 seats in the Senate.

How the incoming Trump administration will deal with congressional procedures is not yet clear. If the administration follows the rules and traditions used in the past, Republicans can get ACA de-funding measures through the Senate with 51 votes, but they will probably need 60 votes, including at least eight votes from Democrats and independents, to get any bills that fully replace or change the ACA or ACA programs through the Senate.

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