House Speaker Paul Ryan and his allies had what looked like thebig gorilla of efforts to change the Affordable Care Act.

Now that the American Health Care Act bill appears to be dead,or, at least is doing a convincing job of playing dead, otherACA-change proposals are getting more attention.

Any would-be ACA changers who want to make some kind of healthcoverage available to consumers in the individual market in 2018need to act quickly, because health insurers are supposed to bedeveloping filings for 2018 products now.

Even carriers willing to overlook the reality that making aprofit in the individual market has been difficult since January2014 are having a hard time knowing how they can sell sustainablecoverage in 2018 without knowing what the support programs, orbasic market rules, might look like.

Here's a look at four possible solutions that are now gettingmore attention.

1. Ask Seema Verma

Tom Bulleit, a Washington-based partner at Ropes & Gray LLP,said in a written commentary about the cancellation of the AHCAbill vote that one obvious outcome could big a bigger role for theU.S. Department of Health and Human Services, and the new HHSsecretary, Tom Price.

Price “may undertake larger administrative efforts to roll backAffordable Care Act rules,” Bulleit said.

One example, he said, is the ACA essential health benefitspackage, or requirement that an individual or small-group majormedical plan cover at least about 60% of the actuarial value of astandardized benefits package that includes 10 types ofbenefits.

Many Republicans would like to eliminate the EHB packagemandate.

“Instead of repealing the 10 essential health benefits, HHScould issue new rules narrowing their definition, which might do abetter job of threading the needle between moderates andconservatives than the blunt instrument of outright repeal,”Bulleit said.

But Price is an orthopedic surgeon and a former member of theHouse, not someone who's had much experience with public or privatehealth insurance.

Seema Verma, the new administrator of the Centers for Medicare& Medicaid Services, the HHS arm directly in charge of ACAcommercial health insurance programs, such as HealthCare.gov, isfamous for being the woman who figured out how to build healthreimbursement arrangements into Medicaid coverage for moderatelylow income adults.

She also owned a consulting firm that has worked closely withprivate insurers and actuarial firms for years, and her firm hadthe contract to train Indiana's navigators how to enroll people incoverage through HealthCare.gov.

She's also open to learning more about how the individual healthinsurance market is really working by, for example, talking toinsurance agents and brokers: The Baton Rouge, La.-based HealthAgents for America reports that Verma's office is trying to bringHAFA agents in for a meeting.

2. Repealing the Affordable Care Act

Crafters of the AHCA bill called it an ACA repeal effort, but itwas really a piece of legislation designed mainly to change ACAbudget provisions. The drafters wrote it that way becauseRepublicans hold just 52 seats in the Senate, and a budget measurecan get through the Senate with just 51 votes, rather than the 60normally needed to push a bill onto the Senate floor.

But some members of Congress have already introduced true ACArepeal bills.

Rep. Steve King (R-Iowa) has introduced H.R. 175, the ObamaCareRepeal Act bill, which would simply repeal the Patient Protectionand Affordable Care of 2010 and the health care provisions in theHealth Care and Education Reconciliation Act of 2010.

Rep. Bill Flores (R-Texas) has introduced a slightly longerbill, H.R. 370. That bill would repeal PPACA and the health careportions of the HCERA, and it would exempt ACA repeal from theusual federal budget impact reduction requirements.

On the one hand: Those bills might do more to increase thenumber of uninsured people and drive up the federal budget deficitthan the AHCA bill.

But, on the other hand: The simplicity of the bills might havesome appeal for the many Republicans who truly want to repeal theACA, not just change it. If ACA programs started doing poorlyenough, it's theoretically possible that some Democrats could warmup to the idea of simply eliminating the ACA and daring everyone tofill the vacuum.

3. Covering Everyone

Colorado voters were Democratic enough to give the state'sElectoral College votes to Hillary Clinton in November, and theysent Michael Bennet, a Democrat, back to the Senate.

But they killed a single-payer health care system bill by a voteof 79.4% to 20.6%.

The Colorado vote got little attention outside of Colorado,however, and Sen. Bernie Sanders (D-Vt.) has been able to use hispersonal popularity to build support for the conceptnationwide.

He has tweeted about health care often.

“Now more than ever we need to recognize that health care is aright,” Sanders tweeted. “People who can't afford health care don'tdeserve to die.”

4. Crossing Party Lines

In Colorado, the state where a single-payer ballot measurecrashed and burned, at least two Democrats have talked openly, andvisibly, about the need for Democrats and Republicans to worktogether to improve the ACA.

Rep. Diana DeGette (D-Colo.) gave an interview calling forbipartisan action to The New York Times.

Rep. Jared Polis (D-Colo.) talked about the need for bipartisanaction while the powerful House Rules Committee was getting theAHCA bill ready for its ill-fated trip toward the House floor.

Meanwhile, Sen. Susan Collins, (R-Maine) and Sen. Bill Cassidy(D-La.) are reminding everyone about an ACA change proposal, thePatient Freedom Act of 2017 bill, they released in 2017: Theirproposal would let each state choose whether to stick with the ACAframework or shift to a more flexible system.

“The PFA takes power from Washington and returns it to statecapitols and individuals,” Cassidy said in a statement about theproposal.

Other veteran Republican senators, including Charles Grassley ofIowa and Lamar Alexander of Tennessee, are also pushing for abipartisan solution.