The 115th Congress sees an opportunity to change one of the most contentious laws in the country.

But the American Medical Association and other major trade groups want members of Congress to put their heads together and offer improvements to the Affordable Care Act as they look to replace it. In an open letter to congressional leaders, AMA CEO James Madara emphasized to legislators that it was open to changes in the law, but they should not come at the cost of the healthcare coverage of millions of people.

AMA represents more than a quarter-million doctors, along with nearly 190 medical groups across the spectrum.

“In considering opportunities to make coverage more affordable and accessible to all Americans, it is essential that gains in the number of Americans with health insurance coverage be maintained,” Madara wrote in his letter, published on Tuesday.

He added that any replacement plan should explain “in reasonable detail, what will replace current policies.” Whatever progress is made on the issue, however, AMA has pledged to work with legislators on finding a solution.

House Speaker Paul Ryan (R-WI) said Congress would focus on transition legislation this year, while Sen. Rand Paul (R-KY) emphasized that without a replacement, insurance markets could collapse.

“I think it’s imperative that Republicans do a replacement simultaneous to repeal,” Paul said, according to ABC News.

Other Groups Have Their Say

AMA isn’t alone in speaking up on this issue. For example, the American Hospital Association and the Federation of American Hospitals, for example, noted in a news conference last month that hospitals stood to lose an “unsettling” amount of money if the law were to be repealed without a replacement.

America’s Health Insurance Plans, a major trade group for insurers, also has argued in favor of a “workable replacement” for the current law.

“The individual mandate, requiring everyone to have insurance, will likely be removed,” AHIP President and CEO Marilyn Tavenner wrote in a Washington Post op-ed last month. “However, to continue the reforms that people want—such as making certain that those with preexisting health conditions can obtain insurance at an affordable price—we need to find alternative ways for people to get and stay covered.”

The Post noted this week that the insurer group is arguing that changes eliminate taxes on insurance added by the current law and recommends strong financial incentives for coverage in place of the individual mandate.

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